Medical Questions > Conditions and Diseases > Spleen Forum

Pain Under Left Side of Rib Cage (Page 8)


March 30th, 2006
Experienced User
Ibs
We all have stomachaches and trouble going to the bathroom once in a while, but for people with ibs, the chronic pain and discomfort can be disabling.

Along with abdominal cramping and discomfort, ibs symptoms include:

bloating
gas
constipation -- the stool comes out either lumpy or hard
diarrhea -- the stool comes out loose or watery
alternating bouts of constipation and diarrhea
bowel movements that feel uncontrollably urgent, difficult to pass, or incomplete
clear or white mucus with the stool
|
Did you find this post helpful?

replied March 30th, 2006
Experienced User
Ibs
Irritable bowel syndrome
more than 37 million americans suffer from irritable bowel syndrome, or ibs, a condition that affects the movement of food through the intestines. For some, the movement is too slow, causing constipation. For others, the movement is too fast, causing diarrhea. In still others, the movement alternates between too fast and too slow causing both diarrhea and constipation. When there is an infection or damage, or when the intestines become too full from gassy food, the nerve cells are activated and it is felt as pain.

Irritable bowel syndrome affects around 15-22% of the people in the united states. It usually starts in people in their 20s and 30s and tends to affect women more than men. Fortunately, these symptoms are not caused by physical damage to the intestines. Although once thought to be due to stress, it is now known that many factors contribute to ibs, including certain foods, eating habits, and imbalances in intestinal flora. Healthy food choices can be very helpful in alleviating the symptoms of this painful and inconvenient condition.


Eat more
whole grains for their high fiber content
organically grown fruits and vegetables
yogurt
avoid adverse food reactions, caffeine, excessive fructose (sugar from fruit), sorbitol (sugars found in plums, peaches, pears and apples) and lactose found in milk and cheese.

Description
dietary causes
nutrient needs
nutrient excesses
recommended diet
references
description
what is irritable bowel syndrome?
Irritable bowel syndrome affects around 15-22% of the people in the united states. It usually starts in people in their 20s and 30s and tends to affect women more than men.

Ibs accounts for up to 3.5 million doctor visits and 2.2 million prescriptions for medication every year. Although symptoms are not caused by physical damage to the intestines, ibs sufferers are much more likely than others to have had surgeries such as appendectomies and hysterectomies, as well as multiple abdominal surgeries. The good news is that dietary changes can really help to reduce symptoms in ibs sufferers.

Symptoms
ibs typically strikes the small and large intestines, which leads to symptoms that occur in the lower abdominal area of the body. The main symptoms include changes in bowel movements.

Symptoms of irritable bowel syndrome include:
periods of constipation, diarrhea, or switching between the two
crampy lower abdominal pain that is better after bowel movements
excessive amounts of gas
a feeling of fullness or bloating in the lower abdomen
note: if you are experiencing any of the following: severe abdominal pain, pain that is constant and not relieved by bowel movements, pain or diarrhea that wakes you from sleeping, unexplained weight loss, vomiting, bleeding from the bowels or blood in the stools, anemia or general weakness, or bowel changes plus a family history of colon cancer, you may have a more serious condition and should see a doctor for a more thorough evaluation.

The disease process
for many years, doctors believed that ibs was just a psychological condition, or “all in your head.” it is now known that this is not the case. Ibs is a real physical ailment that causes very real suffering.

The good news is that there's nothing physically wrong with the intestines. Basically, there are no lesions or deformities or signs of damage that would explain the problem. Instead, the problems seem to be caused by altered intestinal motility and sensation.

The large and small intestines are like big tubes. The insides of the tubes are where the food passes through. Wrapped around the outside of the tube are many layers of muscles. These muscles contract in a certain pattern in order to help squeeze food through the digestive tract. The contraction of these muscle is referred to as motility. Within the layers of muscle cells are the nerve cells that detect pain in the intestines. This is sensation.

When there is an infection or damage, or when the intestines become too full from gassy food, the nerve cells are activated and it is felt as pain. Normally, the muscle cells move food through the small intestines to the large intestines. When it starts to fill the rectum, the final portion of the large intestine, it signals to the brain that it's time for a bowel movement, and we head to the bathroom.

In people with ibs, however, there are problems with motility and sensation. The muscle cells in the large intestines of some patients don’t contract as well as they should, which leads to constipation. In others, the muscles contract more than they should, causing diarrhea. In still others, the muscles alternate so that there are periods of constipation and periods of diarrhea.

At the same time, the nerve cells seem to be hypersensitive. They feel pain much more easily than the nerve cells of other people, so that even the slightest amount of bloating or gas causes a great deal of discomfort. When the patient has a bowel movement, the rectum is emptied, the intestinal contents shift, and the pain subsides.

Causes
the cause of ibs is still considered to be unknown. Although stress can make the condition worse, it is not the only factor involved. Some cases of ibs occur after a bout of intestinal infection, suggesting that infection may play a role for some. Many women report that their symptoms are worse around their menses, suggesting that hormones may play a role for some.

One factor that seems related for many people is the balance of flora in the gut. The large intestines normally contain a variety of friendly bacteria. These beneficial bacteria live on fiber and undigested food and protect us against harmful bacteria and viruses.

Sometimes, however, more harmful bacteria can start to live in the intestines. These can cause symptoms of diarrhea and can create a lot of gas and bloating. Studies have shown that patients with ibs tend to have more of the harmful bacteria in their intestines than others, which can contribute to symptoms.

Whatever the exact cause of the ibs symptoms, be it past infection, hormones, stress, or flora imbalance, dietary changes can have a significant impact on the pain and discomfort experienced by so many people.

Dietary causes
when constipation is the main symptom of ibs, researchers believe the condition is caused by too little fiber in the diet. It's recommended that people eat from 25-30 grams of fiber a day. Unfortunately, the average american only gets about half of this. Without fiber, there is little bulk to the stools, which makes it more difficult to have a bowel movement.

Sugar maldigestion is another possible dietary cause of ibs. Sugars are normally broken down by specific enzymes in the intestines and then absorbed. Some people, however, don’t produce some of these enzymes, so the sugars don’t get broken down properly. If these sugars wind up in the large intestine, the bacteria there will gobble them up and produce large amounts of gas as a result.

Lactose intolerance, the most common form of sugar maldigestion, occurs in people who can’t digest the lactose sugar found in milk. (milk is the only naturally-occurring food known to contain lactose.) another form is called sorbitol intolerance, which involves the sugar sorbitol. Less common, but still occurring, is fructose intolerance, a condition in which some people have trouble digesting large amounts of fructose at once.

Adverse food reactions may also contribute to irritable bowel syndrome. Some people experience a worsening of their symptoms after they eat certain foods. It is unclear why this happens, but eliminating these certain foods from their diets can do wonders to improve symptoms.

The good news is that simple dietary changes can help to alleviate symptoms of ibs. Eating foods like vegetables, legumes, and whole grains that are rich in fiber or yogurt, which is rich in friendly bacteria, may reduce symptoms like constipation, diarrhea, and bloating. In addition, avoiding certain food items like high-fat meals and caffeine can also have a beneficial effect.

Nutrient needs
foods that may help include:
whole grains
whole grains are much more than a small, flavorless, rock-hard bran muffin. Imagine a plate of hot brown rice under a sizzling baked salmon fillet, or a warm piece of honey whole wheat bread with some fresh pumpkin butter, or a hearty serving of beef and barley stew, or a steaming bowl of oatmeal with raisins, diced apple, and banana slices.

Whole grains can add substance and variety to many different meals. They're high in a number of different vitamins and minerals, as well as health-promoting fiber. The fiber found in whole grains has been shown to have very beneficial effects in people suffering from ibs.

Whole grains can help to relieve the pressure and pain caused by constipation. They also help to feed the friendly bacteria to protect against gas and bloating. Refined grain products like white rice and white bread have been stripped of their vital nutrients and fiber, and are not much help for ibs patients. Replacing these over-processed products with some rich, whole grain foods can turn a fiber and nutrient deficient diet into a healthy one.

Fruits and vegetables
if munching on plain, raw celery all day doesn’t appeal to you, try something different like teriyaki stir-fried vegetables with chicken strips, or a warm bowl of butternut squash soup, or a hot baked potato smothered in spicy chili, or a cool mixed-greens salad with tuna.

Instead of snacking on a low-fat, “diet” cookie, try a juicy orange, or some fresh honeydew melon, or some sweet blueberries. The vast number of different fruits and vegetables available at your local grocery store these days is bound to add some variety to your diet.

Fruits and vegetables are packed with nutrients like vitamin c, vitamin e, folic acid, beta-carotene and many more. Fruits and vegetables also have plenty of fiber, which can help with the symptoms of ibs. Studies have shown that increasing fruit and vegetable fiber intake can significantly reduce abdominal pain and improve the overall sense of well-being. Fresh produce is an exciting and essential part of a healthy, whole foods diet.

Yogurt
have you ever wondered how plain milk becomes rich, creamy yogurt? Well, the secret is a bacterial culture that gets added to the milk. The bacteria eat the milk sugar and give yogurt its tart flavor and thick texture. Even more interesting is that the bacteria used to make yogurt are the same kind as the friendly bacteria found in our digestive tracts.

By eating yogurt, we are helping to replenish the supplies of beneficial bacteria in our own bodies. These bacteria may not only protect us from infections with harmful bacteria, they may also provide relief from some of the symptoms of ibs. Ibs sufferers given foods with these bacteria report less painful bloating and gas than before. Instead of grabbing a sugary snack between meals, try the delicate blend of sweet and sour found in a cup of fruit-enriched yogurt.

Nutrients in food that may help include:
fiber
fiber is an essential part of a healthy diet. Fiber adds bulk to the diet and helps stool move easily out of the body. This is especially helpful for people with constipation. In addition, fiber adds substance to the stool, which can help clear up diarrhea. Friendly bacteria in the intestines love fiber and use it as a food source. A diet high in whole-foods fiber will also help the good bacteria to grow and protect us from the harmful bacteria.

It is important for people with ibs to increase their intake of fiber slowly, or symptoms can get temporarily worse before getting better. It's also very important when increasing fiber to also increase your water intake so that stools remain soft and easy to pass.

Some excellent food sources of fiber include raspberries, mustard greens, turnip greens, collard greens, broccoli, cauliflower, and swiss chard.

Lactobacillus
lactobacillus acidophilus is one of the friendly bacteria that lives in the intestines. It is also one of the main bacteria used in a number of fermented milk products such as yogurt. When ibs patients eat these products and ingest these bacteria, they can travel to the intestines and crowd out the harmful bacteria that may be causing symptoms of painful gas and bloating.

The best sources of these bacteria are yogurts that contain live, active culture. It's important to look for yogurts that specifically say they contain live culture, as many types of yogurts are heat-treated to kill the bacteria before being sold. For people who either can't tolerate dairy or who choose not to eat dairy, a number of very tasty soy-based yogurts are currently available at many health food stores.

Nutrient excesses
substances to avoid
fat
high-fat meals can over-stimulate the large intestine. This results in a need to rush to the bathroom right after eating, which can be very unpleasant and inconvenient. Avoiding high-fat meals and eating smaller meals can help prevent this annoying symptom of ibs.

Caffeine
caffeine in the body is actually considered a type of laxative. Caffeine itself is irritating to the large intestine and can over-stimulate the muscles of the large intestine, leading to painful urgency and diarrhea. It's recommended that patients with ibs limit their use of caffeine products such as soft drinks, chocolate, coffee, and black tea.

Adverse food reactions
for unknown reasons, some people find that their ibs symptoms are worse after they eat certain foods. Allergy avoidance diets have been very helpful at relieving the pain and discomfort of irritable bowel syndrome for many patients. Identifying which specific foods are causing the problem and then eliminating these foods can often provide long-term relief.

Adverse food reactions vary according to the individual. Different people may react poorly to completely different foods. Keeping a food and symptom diary or following an allergy avoidance diet may help identify which foods may be problematic.

Sugar maldigestion
some sufferers of ibs find that they have problems digesting certain sugars. When these undigested sugars reach the large intestine, the bacteria there eat them up very quickly and then produce extra gas as a result.

Sugar maldigestion can therefore lead to symptoms of painful bloating as well as diarrhea. Not all ibs patients have problems with sugar maldigestion, but for those who do, eliminating or limiting the intake of these sugars can really help reduce symptoms.

Lactose intolerance
lactose intolerance is much more common in this country than people think, affecting as many as 25% of americans. Lactose is usually broken down by an enzyme known as lactase. When we are babies and breast feed, lactase is sent to us in our mother's milk to help us break down the milk sugar (lactose) that it contains.

As children, we can produce some lactase of our own, but we tend to lose this ability as we become adults. In many parts of the world such as asia and much of africa, close to 100% of adults have stopped producing lactase. In european countries, however, the percentage of adults who don’t produce lactase is closer to 10%. Some studies have shown that as many as 50% of ibs patients may be lactose intolerant without knowing it. A simple test done in your doctor’s office can help determine whether or not lactose intolerance is a problem for you.

Unfortunately, lactose is found in a wide variety of food products such as milk, cheese, yogurt, and ice cream. It may also be hidden in foods such as baked goods, breakfast drink mixes, breakfast cereals, instant potatoes, soups, margarine, breads, non-kosher lunchmeats, salad dressings, candies and snacks, “non-dairy” creamers and whipped toppings, pancake and cake mixes, and some over-the-counter and prescription medications.

People with lactase deficiency must carefully read labels and avoid products that contain milk, powdered milk, milk solids, cheese, and dried milk, as these may contain lactose.

Sorbitol intolerance
sorbitol is a sugar that may cause problems for some people. The sugar itself is named "sorbose," but much more commonly found in food products is an altered form of sorbose, called sorbitol. It's estimated that as much as 43% of caucasians and 55% of non-caucasians are sorbitol intolerant.

Sorbitol is found in high amounts in certain fruits and juices such as peaches, pears, plums, and apple juice. It is also added to many dietetic products such as sugarless chewing gum, diet soft drinks, and dietetic jams. Reducing the intake of these foods can really help to eliminate ibs symptoms in sorbitol intolerant patients.

Fructose intolerance
most people with “fructose intolerance” can eat some fructose, just not in large quantities at once. Fructose is found in most fruits and many other whole foods. It's concentrated in fruit juices and dried fruits, which may be more problematic than fresh fruits. Fructose is especially a problem when it's mixed with sorbitol, as can happen in dietetic jams. Limiting your fruit servings to fresh, whole fruits instead of juices and avoiding foods that mix sorbitol and fructose may be useful for reducing ibs symptoms.

Recommended diet
a diet designed to relieve the symptoms of ibs would contain a wide variety of whole grains, fruits and vegetables, and yogurt.

Refined, nutrient-robbed white flour and rice products would be replaced with hearty, healthy whole grains, perhaps served with tasty sauces, colorful vegetables, or succulent meats. They can add flavor and substance to your diet while also improve your health.

The produce sections of major grocery stores are filled with a wide variety of fresh fruits and vegetables. These add color and flavor as well as a wide range of nutrients and fiber to the diet. Try experimenting with different vegetable dishes or even trying out new vegetables. Fresh fruits can easily take the place of many over-sugared or artificially sweetened diet snacks.

Yogurt is another potential addition to an ibs-friendly diet. Choosing yogurts with live culture and fresh fruit added can get you the benefits of helpful bacteria and nutrient-packed fruit.

Removing certain foods from your diet may seem troublesome. But just think of how many other foods are out there, all of the different grains, vegetables, fruits, legumes, meats, and spices. With a little time and creativity, you won’t even notice that they're gone. But you will notice a large reduction in your ibs symptoms that comes from adopting a healthy foods diet.

The condition specific meal planner for irritable bowel syndrome has menus that cover the nutritional needs of this condition over a four day period.
|
Did you find this post helpful?

replied March 30th, 2006
Experienced User
Ibs
Irritable bowel syndrome
more than 37 million americans suffer from irritable bowel syndrome, or ibs, a condition that affects the movement of food through the intestines. For some, the movement is too slow, causing constipation. For others, the movement is too fast, causing diarrhea. In still others, the movement alternates between too fast and too slow causing both diarrhea and constipation. When there is an infection or damage, or when the intestines become too full from gassy food, the nerve cells are activated and it is felt as pain.

Irritable bowel syndrome affects around 15-22% of the people in the united states. It usually starts in people in their 20s and 30s and tends to affect women more than men. Fortunately, these symptoms are not caused by physical damage to the intestines. Although once thought to be due to stress, it is now known that many factors contribute to ibs, including certain foods, eating habits, and imbalances in intestinal flora. Healthy food choices can be very helpful in alleviating the symptoms of this painful and inconvenient condition.


Eat more
whole grains for their high fiber content
organically grown fruits and vegetables
yogurt
avoid adverse food reactions, caffeine, excessive fructose (sugar from fruit), sorbitol (sugars found in plums, peaches, pears and apples) and lactose found in milk and cheese.

Description
dietary causes
nutrient needs
nutrient excesses
recommended diet
references
description
what is irritable bowel syndrome?
Irritable bowel syndrome affects around 15-22% of the people in the united states. It usually starts in people in their 20s and 30s and tends to affect women more than men.

Ibs accounts for up to 3.5 million doctor visits and 2.2 million prescriptions for medication every year. Although symptoms are not caused by physical damage to the intestines, ibs sufferers are much more likely than others to have had surgeries such as appendectomies and hysterectomies, as well as multiple abdominal surgeries. The good news is that dietary changes can really help to reduce symptoms in ibs sufferers.

Symptoms
ibs typically strikes the small and large intestines, which leads to symptoms that occur in the lower abdominal area of the body. The main symptoms include changes in bowel movements.

Symptoms of irritable bowel syndrome include:
periods of constipation, diarrhea, or switching between the two
crampy lower abdominal pain that is better after bowel movements
excessive amounts of gas
a feeling of fullness or bloating in the lower abdomen
note: if you are experiencing any of the following: severe abdominal pain, pain that is constant and not relieved by bowel movements, pain or diarrhea that wakes you from sleeping, unexplained weight loss, vomiting, bleeding from the bowels or blood in the stools, anemia or general weakness, or bowel changes plus a family history of colon cancer, you may have a more serious condition and should see a doctor for a more thorough evaluation.

The disease process
for many years, doctors believed that ibs was just a psychological condition, or “all in your head.” it is now known that this is not the case. Ibs is a real physical ailment that causes very real suffering.

The good news is that there's nothing physically wrong with the intestines. Basically, there are no lesions or deformities or signs of damage that would explain the problem. Instead, the problems seem to be caused by altered intestinal motility and sensation.

The large and small intestines are like big tubes. The insides of the tubes are where the food passes through. Wrapped around the outside of the tube are many layers of muscles. These muscles contract in a certain pattern in order to help squeeze food through the digestive tract. The contraction of these muscle is referred to as motility. Within the layers of muscle cells are the nerve cells that detect pain in the intestines. This is sensation.

When there is an infection or damage, or when the intestines become too full from gassy food, the nerve cells are activated and it is felt as pain. Normally, the muscle cells move food through the small intestines to the large intestines. When it starts to fill the rectum, the final portion of the large intestine, it signals to the brain that it's time for a bowel movement, and we head to the bathroom.

In people with ibs, however, there are problems with motility and sensation. The muscle cells in the large intestines of some patients don’t contract as well as they should, which leads to constipation. In others, the muscles contract more than they should, causing diarrhea. In still others, the muscles alternate so that there are periods of constipation and periods of diarrhea.

At the same time, the nerve cells seem to be hypersensitive. They feel pain much more easily than the nerve cells of other people, so that even the slightest amount of bloating or gas causes a great deal of discomfort. When the patient has a bowel movement, the rectum is emptied, the intestinal contents shift, and the pain subsides.

Causes
the cause of ibs is still considered to be unknown. Although stress can make the condition worse, it is not the only factor involved. Some cases of ibs occur after a bout of intestinal infection, suggesting that infection may play a role for some. Many women report that their symptoms are worse around their menses, suggesting that hormones may play a role for some.

One factor that seems related for many people is the balance of flora in the gut. The large intestines normally contain a variety of friendly bacteria. These beneficial bacteria live on fiber and undigested food and protect us against harmful bacteria and viruses.

Sometimes, however, more harmful bacteria can start to live in the intestines. These can cause symptoms of diarrhea and can create a lot of gas and bloating. Studies have shown that patients with ibs tend to have more of the harmful bacteria in their intestines than others, which can contribute to symptoms.

Whatever the exact cause of the ibs symptoms, be it past infection, hormones, stress, or flora imbalance, dietary changes can have a significant impact on the pain and discomfort experienced by so many people.

Dietary causes
when constipation is the main symptom of ibs, researchers believe the condition is caused by too little fiber in the diet. It's recommended that people eat from 25-30 grams of fiber a day. Unfortunately, the average american only gets about half of this. Without fiber, there is little bulk to the stools, which makes it more difficult to have a bowel movement.

Sugar maldigestion is another possible dietary cause of ibs. Sugars are normally broken down by specific enzymes in the intestines and then absorbed. Some people, however, don’t produce some of these enzymes, so the sugars don’t get broken down properly. If these sugars wind up in the large intestine, the bacteria there will gobble them up and produce large amounts of gas as a result.

Lactose intolerance, the most common form of sugar maldigestion, occurs in people who can’t digest the lactose sugar found in milk. (milk is the only naturally-occurring food known to contain lactose.) another form is called sorbitol intolerance, which involves the sugar sorbitol. Less common, but still occurring, is fructose intolerance, a condition in which some people have trouble digesting large amounts of fructose at once.

Adverse food reactions may also contribute to irritable bowel syndrome. Some people experience a worsening of their symptoms after they eat certain foods. It is unclear why this happens, but eliminating these certain foods from their diets can do wonders to improve symptoms.

The good news is that simple dietary changes can help to alleviate symptoms of ibs. Eating foods like vegetables, legumes, and whole grains that are rich in fiber or yogurt, which is rich in friendly bacteria, may reduce symptoms like constipation, diarrhea, and bloating. In addition, avoiding certain food items like high-fat meals and caffeine can also have a beneficial effect.

Nutrient needs
foods that may help include:
whole grains
whole grains are much more than a small, flavorless, rock-hard bran muffin. Imagine a plate of hot brown rice under a sizzling baked salmon fillet, or a warm piece of honey whole wheat bread with some fresh pumpkin butter, or a hearty serving of beef and barley stew, or a steaming bowl of oatmeal with raisins, diced apple, and banana slices.

Whole grains can add substance and variety to many different meals. They're high in a number of different vitamins and minerals, as well as health-promoting fiber. The fiber found in whole grains has been shown to have very beneficial effects in people suffering from ibs.

Whole grains can help to relieve the pressure and pain caused by constipation. They also help to feed the friendly bacteria to protect against gas and bloating. Refined grain products like white rice and white bread have been stripped of their vital nutrients and fiber, and are not much help for ibs patients. Replacing these over-processed products with some rich, whole grain foods can turn a fiber and nutrient deficient diet into a healthy one.

Fruits and vegetables
if munching on plain, raw celery all day doesn’t appeal to you, try something different like teriyaki stir-fried vegetables with chicken strips, or a warm bowl of butternut squash soup, or a hot baked potato smothered in spicy chili, or a cool mixed-greens salad with tuna.

Instead of snacking on a low-fat, “diet” cookie, try a juicy orange, or some fresh honeydew melon, or some sweet blueberries. The vast number of different fruits and vegetables available at your local grocery store these days is bound to add some variety to your diet.

Fruits and vegetables are packed with nutrients like vitamin c, vitamin e, folic acid, beta-carotene and many more. Fruits and vegetables also have plenty of fiber, which can help with the symptoms of ibs. Studies have shown that increasing fruit and vegetable fiber intake can significantly reduce abdominal pain and improve the overall sense of well-being. Fresh produce is an exciting and essential part of a healthy, whole foods diet.

Yogurt
have you ever wondered how plain milk becomes rich, creamy yogurt? Well, the secret is a bacterial culture that gets added to the milk. The bacteria eat the milk sugar and give yogurt its tart flavor and thick texture. Even more interesting is that the bacteria used to make yogurt are the same kind as the friendly bacteria found in our digestive tracts.

By eating yogurt, we are helping to replenish the supplies of beneficial bacteria in our own bodies. These bacteria may not only protect us from infections with harmful bacteria, they may also provide relief from some of the symptoms of ibs. Ibs sufferers given foods with these bacteria report less painful bloating and gas than before. Instead of grabbing a sugary snack between meals, try the delicate blend of sweet and sour found in a cup of fruit-enriched yogurt.

Nutrients in food that may help include:
fiber
fiber is an essential part of a healthy diet. Fiber adds bulk to the diet and helps stool move easily out of the body. This is especially helpful for people with constipation. In addition, fiber adds substance to the stool, which can help clear up diarrhea. Friendly bacteria in the intestines love fiber and use it as a food source. A diet high in whole-foods fiber will also help the good bacteria to grow and protect us from the harmful bacteria.

It is important for people with ibs to increase their intake of fiber slowly, or symptoms can get temporarily worse before getting better. It's also very important when increasing fiber to also increase your water intake so that stools remain soft and easy to pass.

Some excellent food sources of fiber include raspberries, mustard greens, turnip greens, collard greens, broccoli, cauliflower, and swiss chard.

Lactobacillus
lactobacillus acidophilus is one of the friendly bacteria that lives in the intestines. It is also one of the main bacteria used in a number of fermented milk products such as yogurt. When ibs patients eat these products and ingest these bacteria, they can travel to the intestines and crowd out the harmful bacteria that may be causing symptoms of painful gas and bloating.

The best sources of these bacteria are yogurts that contain live, active culture. It's important to look for yogurts that specifically say they contain live culture, as many types of yogurts are heat-treated to kill the bacteria before being sold. For people who either can't tolerate dairy or who choose not to eat dairy, a number of very tasty soy-based yogurts are currently available at many health food stores.

Nutrient excesses
substances to avoid
fat
high-fat meals can over-stimulate the large intestine. This results in a need to rush to the bathroom right after eating, which can be very unpleasant and inconvenient. Avoiding high-fat meals and eating smaller meals can help prevent this annoying symptom of ibs.

Caffeine
caffeine in the body is actually considered a type of laxative. Caffeine itself is irritating to the large intestine and can over-stimulate the muscles of the large intestine, leading to painful urgency and diarrhea. It's recommended that patients with ibs limit their use of caffeine products such as soft drinks, chocolate, coffee, and black tea.

Adverse food reactions
for unknown reasons, some people find that their ibs symptoms are worse after they eat certain foods. Allergy avoidance diets have been very helpful at relieving the pain and discomfort of irritable bowel syndrome for many patients. Identifying which specific foods are causing the problem and then eliminating these foods can often provide long-term relief.

Adverse food reactions vary according to the individual. Different people may react poorly to completely different foods. Keeping a food and symptom diary or following an allergy avoidance diet may help identify which foods may be problematic.

Sugar maldigestion
some sufferers of ibs find that they have problems digesting certain sugars. When these undigested sugars reach the large intestine, the bacteria there eat them up very quickly and then produce extra gas as a result.

Sugar maldigestion can therefore lead to symptoms of painful bloating as well as diarrhea. Not all ibs patients have problems with sugar maldigestion, but for those who do, eliminating or limiting the intake of these sugars can really help reduce symptoms.

Lactose intolerance
lactose intolerance is much more common in this country than people think, affecting as many as 25% of americans. Lactose is usually broken down by an enzyme known as lactase. When we are babies and breast feed, lactase is sent to us in our mother's milk to help us break down the milk sugar (lactose) that it contains.

As children, we can produce some lactase of our own, but we tend to lose this ability as we become adults. In many parts of the world such as asia and much of africa, close to 100% of adults have stopped producing lactase. In european countries, however, the percentage of adults who don’t produce lactase is closer to 10%. Some studies have shown that as many as 50% of ibs patients may be lactose intolerant without knowing it. A simple test done in your doctor’s office can help determine whether or not lactose intolerance is a problem for you.

Unfortunately, lactose is found in a wide variety of food products such as milk, cheese, yogurt, and ice cream. It may also be hidden in foods such as baked goods, breakfast drink mixes, breakfast cereals, instant potatoes, soups, margarine, breads, non-kosher lunchmeats, salad dressings, candies and snacks, “non-dairy” creamers and whipped toppings, pancake and cake mixes, and some over-the-counter and prescription medications.

People with lactase deficiency must carefully read labels and avoid products that contain milk, powdered milk, milk solids, cheese, and dried milk, as these may contain lactose.

Sorbitol intolerance
sorbitol is a sugar that may cause problems for some people. The sugar itself is named "sorbose," but much more commonly found in food products is an altered form of sorbose, called sorbitol. It's estimated that as much as 43% of caucasians and 55% of non-caucasians are sorbitol intolerant.

Sorbitol is found in high amounts in certain fruits and juices such as peaches, pears, plums, and apple juice. It is also added to many dietetic products such as sugarless chewing gum, diet soft drinks, and dietetic jams. Reducing the intake of these foods can really help to eliminate ibs symptoms in sorbitol intolerant patients.

Fructose intolerance
most people with “fructose intolerance” can eat some fructose, just not in large quantities at once. Fructose is found in most fruits and many other whole foods. It's concentrated in fruit juices and dried fruits, which may be more problematic than fresh fruits. Fructose is especially a problem when it's mixed with sorbitol, as can happen in dietetic jams. Limiting your fruit servings to fresh, whole fruits instead of juices and avoiding foods that mix sorbitol and fructose may be useful for reducing ibs symptoms.

Recommended diet
a diet designed to relieve the symptoms of ibs would contain a wide variety of whole grains, fruits and vegetables, and yogurt.

Refined, nutrient-robbed white flour and rice products would be replaced with hearty, healthy whole grains, perhaps served with tasty sauces, colorful vegetables, or succulent meats. They can add flavor and substance to your diet while also improve your health.

The produce sections of major grocery stores are filled with a wide variety of fresh fruits and vegetables. These add color and flavor as well as a wide range of nutrients and fiber to the diet. Try experimenting with different vegetable dishes or even trying out new vegetables. Fresh fruits can easily take the place of many over-sugared or artificially sweetened diet snacks.

Yogurt is another potential addition to an ibs-friendly diet. Choosing yogurts with live culture and fresh fruit added can get you the benefits of helpful bacteria and nutrient-packed fruit.

Removing certain foods from your diet may seem troublesome. But just think of how many other foods are out there, all of the different grains, vegetables, fruits, legumes, meats, and spices. With a little time and creativity, you won’t even notice that they're gone. But you will notice a large reduction in your ibs symptoms that comes from adopting a healthy foods diet.

The condition specific meal planner for irritable bowel syndrome has menus that cover the nutritional needs of this condition over a four day period.
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replied March 30th, 2006
Experienced User
Ibs
Topic: should I have tests for irritable bowel syndrome (ibs)?

Introduction

this information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

Key points in making your decision
there are no tests that can definitively diagnose irritable bowel syndrome (ibs). Instead, experts have developed a set of criteria, called the rome ii criteria, that help your doctor decide whether you may have ibs. Your doctor will likely ask you a lot of questions about your symptoms and see how well your symptoms match these criteria. Consider the following when making your decision:

if you have ibs, test results will be normal.
An abnormal test result may mean you have a problem other than ibs.
If your tests are all normal and your symptoms match the symptom criteria common in people with ibs, you probably do not have a serious disorder. You and your doctor can then focus on managing your symptoms so that they do not interfere with your life.
In general, weigh the likelihood that you may have a more serious problem against the risks, discomfort, and costs of more testing. Testing is the only way to be completely certain that you do not have a more serious problem, but if your symptoms match the criteria for ibs and your doctor is confident that you do not have a more serious problem, further testing is probably not necessary.


Medical information

what is irritable bowel syndrome (ibs)?
Irritable bowel syndrome (ibs) is a common digestive problem. Many people have symptoms of ibs (such as diarrhea, constipation, bloating, or abdominal pain) and never see a doctor about them. Other people may choose to see a doctor because they are concerned about their symptoms or because the symptoms are affecting their life.

The goal of managing ibs is to improve your quality of life by reducing the symptoms. However, even with good treatment, you may still have some symptoms. Doctors do not fully understand all the factors that may cause ibs. They know that ibs does not lead to other, more serious problems. However, some people may have both ibs and another digestive disorder.

What can tests for other digestive system disorders show?
In general, if you have ibs, all of your test results will be normal. If your symptoms match those of other people who have ibs, you and your doctor may feel confident about the diagnosis.

The tests your doctor may do depend in part on your most bothersome symptoms. For example, diarrhea may be a symptom of infection with a parasite, such as giardiasis. If you have diarrhea, your doctor may do a stool analysis to check for this kind of problem. The doctor also may do a flexible sigmoidoscopy or colonoscopy to look at the mucous lining of the colon and may take a sample of the lining to check for inflammation (colitis).

If you have an abnormal test result, it may mean you have a problem other than ibs. You also may have both ibs and another problem.

Blood tests can show signs that you may have another illness or infection.
Stool analysis can show infection with bacteria or parasites (such as giardiasis).
A test for blood in the stool may show blood, which means there may be inflammation or bleeding in some part of the digestive tract.
Tests for lactose intolerance, which may include a breath test or trial of a lactose-free diet, may show that you have trouble digesting lactose. For more information, see the topic lactose intolerance.
Sigmoidoscopy may show colon diseases such as inflammatory bowel disease, colon polyps, or diverticulosis.
Colonoscopy or a barium enema may show problems in the colon, such as inflammatory bowel disease, polyps, or diverticulosis.
Depending on your age and history and your doctor's preferences for testing for bowel problems, these tests may be recommended at your first visit for symptoms of ibs.

What can you do with the information you get from these tests?
If your tests are all normal and your symptoms match the symptom criteria common in people with ibs, you may feel reassured that you do not have a serious disorder. You and your doctor can then focus on managing your symptoms so that they do not interfere with your life.

In general, consider the likelihood that you may have a more serious problem compared with the risks, discomfort, and costs of more testing. Without testing, you cannot be completely certain that you do not have a more serious problem. However, if your symptoms match the criteria for ibs and your doctor feels confident that you do not have a more serious problem, more testing is probably not necessary.

What new problems could develop if you have tests?
Most tests have some risks, although the likelihood of a serious complication caused by testing is low. Some of the tests, such as flexible sigmoidoscopy or colonoscopy, may be uncomfortable. In fact, people with ibs may find flexible sigmoidoscopy more uncomfortable than do people who do not have this disorder.

What are the risks of not having tests?
There is generally little risk in not having tests for other possible causes of symptoms if your symptoms match those of ibs. The symptom criteria for diagnosing this condition can help doctors distinguish between people who have ibs and people who have other problems. The more of these symptoms that are present, the more likely it is that you have ibs.1

if you have a more serious problem, your symptoms often will become worse. The presence of "alarm symptoms" also may indicate a more serious problem. Alarm symptoms include fever, unexplained weight loss, blood in your stools, anemia, or a family history of colon cancer or inflammatory bowel disease. Additional tests will usually be recommended in either case.

If you need more information, see the topic irritable bowel syndrome (ibs).


Your information

this information will be helpful if you have symptoms that your doctor believes are caused by irritable bowel syndrome. Your doctor may have done some tests, such as blood tests and a stool analysis, and now you are considering whether to have an image test, such as a flexible sigmoidoscopy, barium enema, or colonoscopy.

This information may not apply to you if:

you are over age 50.
You have blood or pus in your stool.
Your symptoms have come on quickly over the past few weeks to months.
You have had unexplained weight loss, fever, or diarrhea at night.
Your pain wakes you up at night.
In these situations, your doctor will generally want to do more tests to rule out a possibly more serious problem.

In general, your choices are:

accept a diagnosis of irritable bowel syndrome. Try treatment for your most bothersome symptom. Reassess your symptoms in several weeks. If they are improving, you and your doctor may feel reassured that you have ibs rather than another problem.
Have more tests to rule out a more serious problem.
Doctors have different ways of working with people who have symptoms of irritable bowel syndrome. No single approach is correct in all situations.

The decision whether to have tests for irritable bowel syndrome takes into account your personal feelings and the medical facts.

Reasons to have tests for ibs
reasons to not have tests for ibs

you have one or more "alarm symptoms," which include blood in stools, fever, unexplained weight loss, and family history of colon cancer.
Your symptoms don't match up well with the symptom criteria for ibs.
Simple home treatments, including changes to diet and lifestyle, have not helped to relieve your symptoms.
You are over age 50.
Your symptoms do not change in response to stress.
Are there other reasons you might want to have tests for ibs?
You do not have any of the "alarm symptoms."
your symptoms match the criteria for ibs, which include abdominal pain that lasts for 12 or more weeks and that fits at least two of the following: pain that is relieved after a bowel movement, that is associated with a change in how often you pass stools, or that is associated with a change in the consistency of stools.
Your symptoms improved with home treatment, including changes to diet and lifestyle.
Your symptoms are closely linked to stress.
Are there other reasons you might not want to have tests for ibs?


These personal stories may help you make your decision.


Wise health decision

use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about having tests for irritable bowel syndrome. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

I have one or more "alarm symptoms," which include blood in my stools, fever, unexplained weight loss, and family history of colon cancer. Yes no unsure
my symptoms very closely match the criteria for ibs. Yes no unsure
home treatment has relieved my symptoms. Yes no na*
i am over age 50. Yes no na
my symptoms have come on quickly, over the past few weeks. Yes no unsure
my pain wakes me up at night. Yes no na
i am willing to try changes in diet and lifestyle before having further tests done. Yes no unsure

*na=not applicable

use the following spaces to list any other important concerns you have about this decision.












What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have tests done for irritable bowel syndrome (ibs).

Check the box below that represents your overall impression about your decision.

Leaning toward having tests
leaning toward not having tests



return to the topic irritable bowel syndrome (ibs).


References

citations
talley nj (2000). Treatment of the irritable bowel syndrome. In mm wolfe et al., eds., sleisenger and fordtran's therapy of digestive disorders, pp. 477–490. Philadelphia: w.B. Saunders.


Credits

author christopher hess
editor geri metzger
associate editor tracy landauer
associate editor terrina vail
primary medical reviewer patrice burgess, md
- family medicine
specialist medical reviewer jerome b. Simon, md, frcpc, facp
- gastroenterology
last updated july 12, 2004



go back to:
irritable bowel syndrome (ibs)


------------------------------------------ --------------------------------------

author: christopher hess last updated july 12, 2004
medical review: patrice burgess, md - family medicine
jerome b. Simon, md, frcpc, facp - gastroenterology


© 1995-2006, healthwise, incorporated, p.O. Box 1989, boise, id 83701. All rights reserved.

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information. For more information, click here.












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replied March 30th, 2006
Experienced User
Ibs
Topic: irritable bowel syndrome (ibs)

topic overview

what is irritable bowel syndrome (ibs)?
Irritable bowel syndrome (ibs) is an intestinal disorder that causes abdominal pain or discomfort, cramping or bloating, and diarrhea or constipation. Irritable bowel syndrome is a long-term but manageable condition.

What causes ibs?
The cause of irritable bowel syndrome is not well understood. In ibs, the movement of the digestive tract is impaired, but doctors can find no change in physical structure, such as inflammation or tumors. The symptoms of ibs are thought to be related to faulty communication between the brain and the intestinal tract, which causes abnormal muscle contractions in the intestines.

What are the symptoms?
The main symptoms of irritable bowel syndrome are abdominal pain or discomfort that occurs along with constipation or diarrhea. Other common symptoms are bloating, mucus in the stools, or a sense that you have not completely emptied your bowels.

Many people with ibs have alternating periods of constipation and diarrhea, but often one problem is more common than the other. A given episode may be milder or more severe than the one before it, but the disorder itself does not become worse over time. Irritable bowel syndrome does not lead to more serious diseases, such as inflammatory bowel disease or cancer.

Ibs is one of the most common intestinal disorders. Most people's symptoms are so mild that they never see a doctor for treatment. However, some people may have troublesome symptoms, especially abdominal cramps, bloating, and diarrhea.

How is ibs diagnosed?
Irritable bowel syndrome can usually be diagnosed from symptoms. Your health professional will conduct a medical history and physical examination. In most cases, a few additional tests—such as stool analysis or a sigmoidoscopy, which allows a doctor to examine the inside of the lower part of the intestine (colon)—are needed. Ibs is diagnosed when a person has the typical symptoms of the disorder and routine tests have ruled out other possible causes.

How is it treated?
Irritable bowel syndrome is a long-term but manageable condition. Active involvement in treatment is important to managing it successfully. Treatment is adapted to fit individual needs and usually focuses on changes in diet and lifestyle, avoiding foods that trigger symptoms, and managing stress. Medications may also be used.
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replied March 30th, 2006
Experienced User
Ibs
What is ibs?

Irritable bowel syndrome, or ibs, is a problem that affects mainly the bowel,* which is also called the large intestine. The bowel is the part of the digestive system that makes and stores stool. The word syndrome means a group of symptoms. Ibs is a syndrome because it can cause several symptoms. For example, ibs causes cramping, bloating, gas, diarrhea, and constipation.


*linked terms are defined in the glossary.



Ibs is not a disease. It's a functional disorder, which means that the bowel doesn't work as it should.

With ibs, the nerves and muscles in the bowel are extra-sensitive. For example, the muscles may contract too much when you eat. These contractions can cause cramping and diarrhea during or shortly after a meal. Or the nerves can be overly sensitive to the stretching of the bowel (because of gas, for example). Cramping or pain can result.




Ibs can be painful. But it does not damage the bowel or cause any other diseases.


[top]
does stress cause ibs?

Emotional stress will not cause a person to develop ibs. But if you already have ibs, stress can trigger symptoms. In fact, the bowel can overreact to all sorts of things, including food, exercise, and hormones.




Foods that tend to cause symptoms include milk products, chocolate, alcohol, caffeine, carbonated drinks, and fatty foods. In some cases, simply eating a large meal will trigger symptoms.


Women with ibs often have more symptoms during their menstrual periods.


[top]
what are the symptoms of ibs?

The main symptoms of ibs are

crampy pain in the stomach area (abdomen)


painful diarrhea or constipation


most people have either diarrhea or constipation, but some people have both.


Other symptoms are

mucus in the stool


swollen or bloated abdomen


the feeling that you have not finished a bowel movement


[top]
how is ibs diagnosed?

The doctor will suspect that you have ibs because of your symptoms. But the doctor may do medical tests to make sure you don't have any other diseases that could cause the symptoms.



[top]
medical tests for ibs
physical exam


blood tests


x ray of the bowel: this x-ray test is called a barium enema or lower gi (gastrointestinal) series. Barium is a thick liquid that makes the bowel show up better on the x ray. Before taking the x ray, the doctor will put barium into your bowel through the anus.


Endoscopy: the doctor inserts a thin tube into your bowel. The tube has a camera in it, so the doctor can look at the inside of the bowel to check for problems.



[top]
what is the treatment?

Ibs has no cure, but you can do things to relieve symptoms. Treatment may involve

diet changes
medicine
stress relief
you may have to try a combination of things to see which works best for you.



Diet changes
some foods make ibs worse.


Here are some foods that may cause symptoms:

fatty foods like french fries
milk products like cheese or ice cream
chocolate
alcohol
caffeine (found in coffee and some sodas)
carbonated drinks like soda

these foods may make ibs worse.



If certain foods cause symptoms, you should eat less of them or stop eating them.


To find out which foods are a problem, write down this information:


what you eat during the day


what symptoms you have


when symptoms occur


what foods always make you feel bad


take your notes to the doctor to see if you should stop eating certain foods.


Some foods make ibs better.


Fiber reduces ibs symptoms—especially constipation—because it makes stool soft, bulky, and easier to pass. Fiber is found in bran, bread, cereal, beans, fruit, and vegetables.

Here are some examples of foods with fiber:

fruits vegetables breads, cereals, and beans
apples
peaches broccoli, raw
cabbage
carrots, raw
peas kidney beans
lima beans
whole-grain bread
whole-grain cereal

add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber all at once might cause gas, which can trigger symptoms in a person with ibs.


Besides telling you to eat more foods with fiber, the doctor might also tell you to get more fiber by taking a fiber pill or drinking water mixed with a special high-fiber powder.



How much you eat matters, too.


Large meals can cause cramping and diarrhea in people with ibs. If this happens to you, try eating four or five small meals a day. Or, have your usual three meals, but eat less at each meal.



Medicine

if necessary, the doctor might give you medicine to help with symptoms:

laxatives: to treat constipation


antispasmodics: to slow contractions in the bowel, which helps with diarrhea and pain


antidepressants: to help those who have severe pain


you must follow your doctor's instructions when you use these medicines. Otherwise, you could become dependent on them.


Stress relief
does stress trigger your symptoms? Learning to reduce stress can help. With less stress, you may find that you have less cramping and pain. Also, you may find it easier to manage your symptoms.


Meditation, exercise, and counseling are some things that might help. You may need to try different activities to see what works best for you.

[top]
points to remember
ibs is a functional disorder in which the bowel doesn't work as it should.



Ibs can cause cramping, bloating, gas, diarrhea, and constipation.



Ibs doesn't damage the bowel.



The doctor will diagnose ibs based on your symptoms. You might have some medical tests to rule out other diseases.



Stress doesn't cause ibs, but it can trigger symptoms.



Fatty foods, milk products, chocolate, caffeine, carbonated drinks, and alcohol can trigger symptoms.



Eating foods with fiber and eating smaller meals can reduce symptoms.



Treatment for ibs may include medicine, stress relief, or changes in eating habits.



[top]
glossary
abdomen (ab-doh-men): the area of the stomach.


Barium enema (bar-ee-um en-uh-muh): an x ray of the bowel using a liquid called barium to make the bowel show up better. This test is also called a lower gi (for gastrointestinal) series.


Bowel: the part of the digestive system that makes and stores stool. It is also called the large intestine.


Endoscopy (en-dah-skuh-pee): a test to look at the inside of the bowel.

Functional: refers to how something works.

Mucus: a clear, sticky discharge. It might look white.


Syndrome (sin-drome): a group of symptoms.


[top]
for more information
international foundation for functional gastrointestinal disorders (iffgd) inc.



also, the national digestive diseases information clearinghouse (nddic), which prepared this booklet, has a fact sheet on ibs.
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replied March 30th, 2006
Experienced User
Splenic Flexure Syndrome Associated With Ibs
There is diarrhoea-predominant ibs, constipation-predominant ibs but in practice, this division between constipation-predominant and diarrhoea-predominant ibs is not clear-cut with a category of patients alternating between diarrhoea and constipation. Broadly the symptoms of ibs are:

crampy abdominal pain, often relieved by defaecation/defecation
an alteration in bowel habit (diarrhoea/diarrhea, constipation or alternating)
bloating and (painful) swelling of the abdomen
rumbling noises and excessive passage of wind
increased gastro-colic reflex, this is an awakening of the childhood reflex where food in the stomach stimulates colonic activity, resulting in the need to open the bowels.
Urgency - a need to rush to the toilet and incontinence (if a toilet isn't nearby)
a sharp pain felt low down inside the rectum (proctalgia fugax)
right-sided abdominal pain, either low or under the right lower ribs which does not always get better on opening the bowels; or pain under the left ribs (splenic flexure syndrome) and when the pain is bad it may ascend to the left armpit.
Sensation of incomplete bowel movement
possible associated symptoms are: indigestion, belching, nausea, headaches, dizziness, ringing in the ears, fibromyalgia, backache, passing urine frequently, tiredness or even chronic fatigue, shortness of breath, anxiety and depression
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replied March 30th, 2006
Experienced User
Splenic Flexure Syndrome-correlation to Ibs
Abdominal bloating
bloating is usually the result of an intestinal motility disorder, such as irritable bowel syndrome (ibs). Motility disorders are characterized by abnormal movements and contractions of intestinal muscles. These disorders may give a false sensation of bloating because of an increased sensitivity to gas.
Splenic-flexure syndrome is a chronic disorder that may be caused by gas trapped at bends (flexures) in the colon.
Crohn's disease, colon cancer, or any disease that causes intestinal obstruction, may also cause abdominal bloating.
Internal hernias or adhesions (scar tissue) from surgery may cause bloating or pain.
Fatty foods can delay stomach emptying and cause bloating and discomfort, but not necessarily too much gas.
Abdominal pain and discomfort
gas in the intestine causes pain for some people. When it collects on the left side of the colon, the pain can be confused with heart disease. When it collects on the right side of the colon, the pain may feel like the pain associated with gallstones or appendicitis.
The symptoms of gas may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is gas in the digestive tract diagnosed?
Symptoms of gas may be caused by a serious disorder, which should be determined. In addition to a complete medical history and physical examination, your physician may suggest the following activities to assist in the diagnosis:

food diary
you may be asked to keep a diary of foods and beverages consumed for a specific time period, and/or to count the number of times you pass gas during the day.
Colonoscopy
for people 50 years of age and older, and for those with a family history, the possibility of colorectal cancer is considered. Colonoscopy is a procedure that allows the physician to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the physician to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.




Sigmoidoscopy
a sigmoidoscopy is a diagnostic procedure that allows the physician to examine the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.


Upper gi (gastrointestinal) series (also called barium swallow.)
for chronic belching, your physician will look for signs or causes of excessive air swallowing and may request an upper gi series. An upper gi series is a diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.
Treatment for gas in the digestive tract:
specific treatment for gas in the digestive tract will be determined by your physician based on:

your age, overall health, and medical history
extent of the condition
your tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
preventing gas in the digestive tract:
the most common ways to reduce the discomfort of gas include the following:

changes in the diet
medications
reducing the amount of air swallowed
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replied March 30th, 2006
Experienced User
Information From Another Post On Another Site Ibs/splenic
I am a 36 year old female with a history of severe ibs and chronic constipation. The severe constipation seemed to be kicked off by a combination of fertility treatment, stress and numerous drugs going in and out of my system. Over the past year, I have had the following tests: blood work, thyroid levels, abdominal x-ray, abdominal cat scan, upper gi, lower gi, small bowel follow-through, colonoscopy and colon transit marker study. All tests were normal (plan x-ray showed constipation). Have used the following to treat the constipation: fiber, equalactin, phazyme, zelnorm, miralax, lactulose and senakot s. Currently, i'm taking 1 senakot s per day and this is the only thing that works.


My immediate concern is as follows: about 10 weeks ago, I began experiencing a feeling of abdominal fullness after eating small meals and my upper belly (just below the left rib cage) distends after eating.It's extremely uncomfortable. My doctor has told me that this area is actually my colon and not my stomach. Over the past week, this has gotten worse and is painful when bending over. When I bend over, I get a gripping, cramping pain. The mild distension seems to last through the day now and is only relieved by a bm (and only temporarily). As soon as I eat, it begins again.


I went to a doctor the other day and was give an plain abdominal x-ray. He mentioned that there was nothing noticeable aside for constipation. I took one dose of milk of magnesia that night which threw me into severe spastic colon for about 2 days and irritated the area under by rib more after each trip to the bathroom. Now, after 2 days i'm back to the mild distension and fullness after eating a small meal. Here are my questions: am I experiencing this splenic flexure syndrome? What is the difference between typical splenic flexure syndrome and splenic flexure distension? Should I be concerned that there is a major problem? Or could this be from disfunctional contractions of the colon and constipation? If due to disfunctional colonic contractions, how can I get things to work normally again? Also, any possibility of stomach inflammation or infection? Is there anything else I should ask my doctor to check for? I have a follow-up on monday and am scared that this is getting worse. Note: doctor has told me that stomach is emptying fine due to normal upper gi.
Forum-m.D.-kyp
12/20/2003
alexandria splenic flexure syndrome refers to the trapping of gas at the splenic flexure causing distension and bloating. To answer your questions:

1) it is possible that the increased gas can lead to splenic flexure syndrome. Ibs is one of the more common causes of increased gas.


2) I believe that both splenic flexure syndrome and distension refer to the same condition.

3) you have been through a comprehensive variety of tests and with them coming back normal, it would be unlikely that a serious gi condition would be missed.

4) certainly irritable bowel syndrome can cause the dysfunctional contractions. This can lead to increased gas and bloating.

5) zelnorm has been shown in studies to help with constipation-predominant ibs. Unfortunately, you have already tried this. There are some studies that also show that tricyclic antidepressants have some efficacy in the treatment of ibs.

6) an upper endoscopy (to look for stomach inflammation and biopsy for h pylori) is the most reasonable test to look for stomach inflammation or infection.

If you continue to have constipation despite all available medications, you may want to consider behavioral approaches such as biofeedback or surgical approaches that have been shown to help with chronic constipation. These options should be discussed with your personal physician.

Followup with your personal physician is essential.


This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
kevin, m.D.


The "comments" posted below are provided by individuals and reflect their personal opinions only. Under no circumstances should you act on any advice or opinion posted in this forum. Always check with your personal physician before taking any action regarding your health! Med help international and our partners, sponsors and affiliates have no obligation to monitor any "comments" posted on this site, or the content and/or accuracy of such exchanges. Med help international does not endorse the views of any user.
Neli
12/18/2003
c2 alexandria hi, I have been experiencing the same symptoms you have with severe constipation and pain on my left side arm and always feel full and I only eat small meals cause if I eat large meals I feel sick and I also have chest pains and feel this heavyness and kinda short of breath from the stomach area...I have had numerous scans and test like you with nothing found...Endoscopy, stomach xray, colonoscopy you name it and nothing....I feel with you and I would like to know if you find anything helful....I notice that if I watch what I eat it's ok at times or if I eat fiber it is worse...What I think is lots of gas trapped in the upper stomach which causes all this pain...Try taking gas-x for gas and bloating and see if it helps when you feel bad....Do you have history of anxiety or panic attacks? Cause sometimes when you;re stressed the stomach kinda comes up in your esophagus causing same sensations you mentioned....Anyways what exactly is spenic flexure? I never heard of it.....Let me know if I was helpful in anyways...Thanks


alexandria
12/22/2003
c3 neli thanks for your response! On one of my trips to my regular doctor, he mentioned splenic flexure syndrome. The splenic flexure is where large amounts of gas gets trapped in the bends of your colon. The splenic flexure is one the left side under the rib and there is another flexure under the right rib. Right now, not much helps. Sometimes, taking 1-2 phazyme before meals helps as well as eating 6 very small meals instead of large ones. I'm hoping to find some answers in january as i've been referred to an ibs specialist in nyc.


As for the chronic constipation, have you found anything that has worked? I think part of my problem is a combination of too many medications and stress. Over the past year, i've been put on many medications to the point where nothing is working correctly (things to speed things up and things to slow things down). Second, I was diagnosed with generalized anxiety last march. This is due to a very high stressful job (chronic stress for the past 3 years) and ongoing worry about the colon disfunction. Much of the concern stems from the fact that none of the doctors can tell me what the problem is and how to fix it. And, of course, stress makes everything worse. I've consulted with two colon surgeons who do not feel that colon surgery is appropriate. From what i've been told, most people with severe chronic constipation and who also have another functional disorder (such as ibs) are not good candidates for the surgery. Thesurgery is typical reserved for those with colonic inertia with no other functional problems.


Any other thoughts, comments would be greatly appreciated.


Cowley
01/22/2004
c4 . I to have the pain under my left rib and it is a frighting pain as you alwaya think it is to do with your heart. I have also had it under my right rib to the extent that I was rushed in to hospital as they thought it could of be a blood clot, but after lots of test and neddles they came up with the idea that it could be splenic flexure. I do not sufer from constipation but still have this problem. I am a full time student at the moment and I realy belive that stress has a lot to do with it. When I am over working or an exam is near it always seems to get worse. I also suffer from panic attacks and was put on medication ( amitriptyline) which helped a great deal and I did not suffer with it hardly at all. I have been off it now for 7 weeks after being on 7 months and now the past 3 weeks my pain has arrived back. I will not go back on medication as it made my hair go thin and at 32 years of age that is the last thing that I wanted. I am now going to try stress classes and see if this helps the pain. Its very painfull and can happen at anytime, worse after food, sometimes I wake up at night with it hardly being able to move.
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replied March 30th, 2006
Experienced User
Post From Other Site--ibs/splenic Flexure Syndrome Associ8on
For the past few weeks, I have been experiencing upper left abdominal pain. The pain is slight and it comes and goes. Sometimes I also experience bloating, belching along with the pains. The first time this pain occurred it seemed almost like a runner’s pain, you know that feeling when you run fast and get a pain on your left side. The pain was dull and it would last for most of the day. Sometimes like today I feel that weird pain or discomfort on the upper left side and it almost feels like gas today. I have had ibs for several years now. So just as a precautionary measure I visited my gastroenterologist and he thinks it may be a functional problem so he advised me to up my dose of my anti-spasmatic medication and sent me for an abdominal sonogram. Has anyone experience this? Could this just be another form of the side effects from ibs? Thank you for any advice or insight on this.
Posts: 1 | registered: 21 october 2005

nancycat
very prolific member

posted 21 october 2005 01:17 pm
i think theres a place called the splenic flexure which is near where you feel the pain you describe. I am pretty sure that its a normal place for ibs'rs to notice pain.

Nancy
posts: 1985 | location: massachusetts | registered: 16 july 1999

cynthiag
regular member
posted 22 october 2005 01:02 pm
hi tony, I have the same kind of pain during an ibs-d flareup. Nothing helps but the pain isn't as bad when I lay down. Very frustrating and painful when i'm out and about. If anyone has suggestions to deal with the pain, i'm open for them. Thanks and have a great weekend, cynthia
posts: 44 | location: garland, tx | registered: 17 september 2005

gsmith40
new member
posted 01 november 2005 09:33 am
tony, I too have the exact same pain in the upper left abdominal area and your discription of it is exactly the way I described it to my doctor and they looked at me like I had two heads!!! I thought maybe I was passing kidney stone or something... We even checked out my gallbladder and all tests came back negative. I was diagnosed with ibs due to stress. But it is good to know that there is someone else out there that has had this pain also. It is very frustrating and makes me want to just scream. It comes and goes with no rhyme or reason. Just wanted you to know you are not alone!!
Posts: 1 | registered: 01 november 2005

js_davis
new member
posted 01 november 2005 09:47 am
i have the same pain, except it is one the right side. Can ibs cause this almost constant disocmfort. Can any test see this, like an x ray? I tried an anti-spasmotic, but my acid reflux came back worse.
Posts: 8 | registered: 13 october 2005

suev
very prolific member

posted 01 november 2005 02:33 pm
tony - this is an absolute classic hot spot for pain and discomfort - and yes, its at the splenic flexure. I get it = not often, though i've had a particularly nasty dose of it recently - mine is quite severe stop you in your tracks, followed by hideous gurgling and rumbling and then it passes. No not worry - you are definately not alone on this one.
Sue
posts: 1565 | location: cheshire.Uk | registered: 14 october 2003

harold marple
new member
posted 19 january 2006 08:10 pm
i to have this pain on the left and right side and it does subside when I lie down you are right in saying its like you have been runing to hard the pain is just like a stitch pain.I have got many other symptoms but this pain has been worrying me.I am so glad I have found this site it is so reasureing to know you are not alone.I have been suffering with ibs for the last six months my other symptoms are pain in the lower left hand side,pain in the left pelvic region,pain in middle of abdomen.
Posts: 8 | registered: 19 january 2006

gigi
new member
posted 19 january 2006 11:29 pm
i'm having awful sharp gas pain in my upper left abdominal area - right under the breastbone. Woke up with it this morning and here it is 11 at night and it's still hurting. I can't take a deep breath and can't do anything active for fear of getting winded. Just normal breathing hurts! I've had this a couple of other times in my life - the first time it happened I went to the emergency room thinking I was having a heart attack and they gave me a "cocktail" of maalox and some other thing that did no good. The pain lasted for days after that. All part of the ibs I guess, but has anyone found any over the counter...Or herbal, or home-made remedies that have helped you with this sort of thing? I just don't have the luxury of being able to stay home and take it easy this time around...Need to get quality rest at night and be able to function at work fully. Any suggestions??
Posts: 1 | registered: 19 january 2006

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replied April 1st, 2006
Experienced User
Hi There. Information Regarding the Abdominal Ct Scan
If anyone is considering having the abdominal ct scan done--you will have to fast before the test (no food/water)--drink barium before the test (given to you at the hospital) (mine was given to me in a cup--fyi-ask for a straw--helps you to drink it down faster because it doesn't taste that great and without a straw you may sip (which takes longer). Also for people who may smoke (try not to smoke the day before the test) because you will be asked to inhale and hold your breath for a certain amount of time before exhaling (you have to have pretty decent lung capacity for this test). I don't smoke, and even I had trouble holding my breath for the amount of time for this test. They make you hold your breath while taking these pictures (so the organs can be seen more clearly). If you let out any air while holding your breath, it may push the organs out of view of the camera (the guy who was running my test told me that because I was worried because I had trouble holding my breath a couple of times (and felt like I was dizzy) and almost had to let some air out (that I was holding in). He told me that it is best to hold your breath without letting any air out--just so you don't affect any of the pictures being taken (ct scan).
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replied April 1st, 2006
Experienced User
Info About Ibs Remedies
Top 10 remedies for irritable bowel syndrome (ibs)

irritable bowel syndrome (ibs) is a chronic, functional disorder of the gastrointestinal tract characterized by lower abdominal pain (often severe), gas, bloating, vomiting, diarrhea, constipation, or a combination of both, typically over months or years.

Treatments for ibs include changes to diet, anti-spasmodic medications, muscle relaxants, and stress reduction.

Hypnotherapy / self-hypnosis


hypnotherapy is considered a low cost, non-invasive, and comfortable method of treatment.

Gut directed hypnotherapy (gdh) was developed specifically for ibs patients and has been proven to reduce symptoms in 80% of cases. Patients with typical symptoms of ibs have realized the highest success rates for gdh. These symptoms are abdominal pain, bloating, diarrhea and/or constipation. Dr. P.J. Whorwell first introduced it in 1984 at the university hospital of south manchester. Dr. Whorwell studied thirty patients in two groups of 15. One group was given a sugar pill and psychotherapy. The other group was given gdh. The psychotherapy group had some small improvements. The hypnotherapy group had dramatic improvements that lasted past the completion of treatment.

The first session may be devoted to taking a history of the patient's ibs symptoms. Thereafter, each session is tape-recorded, and the patient is instructed to listen to the tape once each day until the next appointment. There may be other tasks assigned to the patient that should be undertaken between sessions. The success of hypnotherapy can be directly related to the commitment of the patient. Attending all the sessions and completing all extra assignments outside of sessions is absolutely necessary. Gdh is not intended as a cure for ibs, but it can help provide a structure in which the patient can assert some measure of control over ibs symptoms.

Colon hydrotherapy (colonics)


colon therapy promotes healthy colon function and can ease a range of problems from headache and backache to arthritis and hypertension. Colon hydrotherapy sessions are used to cleanse the colon for medical procedures such as colonoscopy, sigmoidoscopy, surgery, and barium enemas.

The colon, along with the skin, kidneys, and lungs, is a major organ for eliminating bodily waste. If bowel movements are not consistent, waste products and toxins are not eliminated in a regular manner, and health can be compromised. Colon hydrotherapy is a gentle purified water washing of the large intestine to clean, detoxify and aid in the reconstitution of intestinal flora. The client lies on a massage table and with a colon hydrotherapy machine, water is run very slowly into the colon. When slight pressure builds up in the colon, the water is released. As the water is flowing out through an illuminated glass viewing tube, the abdominal area is thoroughly massaged. To insure maximum sanitation, a disposable water and waste line and applicator are used. With colonic therapy, the condition of the blood is improved as well. The toxic load in the blood stream seems to be reduced whenever the colon and abdominal lymphatics are cleared.

Benefits of colonic therapy.

The water removes the material that may be lodged in the colon.

Some of the water is absorbed into the colon wall, and this promotes a cleansing of the colon itself, leading to greater organ strength and health.

Some of this clean water is absorbed through the colon into the lymphatic system, where it can begin to dissolve the thick or crystallized accumulations of waste that cayce called “drosses.”

if the therapist is trained in the technique, they may also be able to manipulate water pressure and temperature to exercise the colon, and thereby stimulate in a weak, inactive colon an ability for stronger bowel movements.




Alosetron hydrochloride (lotronex)


medications are an important part of relieving ibs symptoms. Lotronex has been re-approved by the u.S. Food and drug administration (fda) for women with severe irritable bowel syndrome who have not responded to conventional therapy and whose primary symptom is diarrhea. However, even in these patients, it should be used with caution because it can have serious side effects, such as severe constipation or decreased blood flow to the colon.

You must do 3 things if you are going to take lotronex:

understand that lotronex has serious risks.

Sign a patient-physician agreement with your doctor.

Follow the directions in this medication guide.

Click here, to learn more about lotronex.

Imodium (loperamide)


antidiarrheals such as loperamide (immodium) are quite effective for diarrhea, and may be prescribed to help with loose, frequent stools. If you use an over-the-counter medication, follow the package directions. If you find yourself using an over-the-counter antidiarrheal medication more than twice a month, talk with your physician. Side effects are infrequent and usually minor, but may include abdominal discomfort, constipation, dry mouth, nausea, fatigue, drowsiness, and allergic reactions.

Zelnorm (tegaserod)


tegaserod maleate (zelnorm) has been approved by the fda for the short-term treatment (usually 4 weeks) of women with irritable bowel syndrome whose primary symptom is constipation. It is the first agent in a new class of drugs called serotonin-4 receptor agonist (5ht4 agonist) developed to target the gi tract.

This prescriptive medication should only be given to adults who are over the age of 18. It should be taken before meals in a dose of 6 mg twice daily for 4-6 weeks. If the patient responds to this drug therapy, a physician may consider an additional 4- to 6-week course of drug therapy. Contraindications to the use of tegaserod maleate include severe liver impairment, severe kidney impairment, history of bowel obstruction, symptomatic gallbladder disease, suspected sphincter of oddi dysfunction, and abdominal adhesions. Tegaserod maleate should not be initiated in patients who are currently experiencing or frequently experiencing diarrhea. Common adverse reactions include abdominal pain, diarrhea, nausea, flatulence, and headache and back pain (pdr 2002). (note: tegaserod meleate will be under close observation by the fda because medications that affect the serotonin system have historically been associated with side effects.)


diet


certain foods may trigger an attack. To identify foods that trigger your symptoms, maintain your usual diet and note what you were eating when your symptoms developed. Look for patterns. Often, symptoms don’t relate to specific foods, rather large amounts of food at one time. You may want to include a dietitian in your treatment plan. He or she may be able to help you assess how your body reacts to certain foods — sometimes a food sensitivity (lactose intolerance is common) may be involved.

Triggers can include caffeine, milk, chocolate, nicotine, alcohol and large, high-fat meals. Traditional therapies have included dietary fiber, especially for treatment of symptoms of constipation. Fiber decreases the transit time through the colon and decreases the pressure in the colon. Increasing your consumption of fresh fruits and vegetables, whole grains and bran may help.

Increased fiber can make symptoms worse for some ibs patients. This is because bacteria in the colon can break down fiber, producing gas, which can make bloating worse.. Discuss this with your health care professional — it may be to your benefit to avoid certain forms of fiber — particularly gas-forming foods such as cabbage, broccoli, cauliflower, and beans. But there’s no conclusive proof that eliminating certain foods will eliminate your symptoms.

Aloe vera (aloe barbadensis)


taken internally, aloe vera juice (processed directly from the gel) appears to ease the discomfort of irritable bowel syndrome (ibs) in many users, and this has been the main reason for aloe vera’s recent surge in popularity. A scourge of modern living, ibs is caused by abnormal spasms of the gut which are made worse by stressful living and poor diets. The unpleasant symptoms include diarrhoea and constipation, gut pain, bloating and wind.
The dosage of aloe vera used by most ibs sufferers is two teaspoons twice a day, or half this amount diluted with water if using a double strength juice. Flavoured juices - e.G. Red grape or tropical fruit - are also available, or for times when using the liquid may be inconvenient, it is also possible to get concentrated aloe vera tablets (but these aren’t thought to be as beneficial over the longer term). Some people claim to notice an immediate effect of aloe vera in ibs, whilst others indicate a more progressive benefit over a few months.



Bentyl etc. (dicyclomine)


bentyl (dicyclomine) is an anticholinergic. It prevents spasms in the muscles of the gut and bladder by relaxing them, and reduces the amount of stomach acid produced. It comes in the forms of capsule, tablet, and oral liquid. It is usually taken four times per day. For best results, bentyl should be taken 30 minutes to 1 hour before eating a meal. Bentyl should not be taken at the same time as an antacid. Antacids can reduce the effectiveness of bentyl.

Serious side effects of bentyl include mental changes such as confusion, short-term memory loss, hallucinations or agitation. In most cases, these side effects are gone in the 12 to 24 hours after the patient stops taking bentyl. Other side effects can include drowsiness, dizziness, and a decreased ability to perspire (which can contribute to heat stroke).

Laxatives


metamucil etc. (fiber/bulk-forming)- if you are constipated, your doctor may suggest bulk-forming laxatives containing psyllium (metamucil).

There are two types of laxatives, osmotic and stimulant. Osmotic laxatives are not absorbed and most require a prescription. They soften the stool and have an onset of action of one to three days. One type of osmotic laxative is polyethylene glycol, or peg (a brand name is miralax). Another is unabsorbed carbohydrate (lactulose and sorbitol). Glycerine suppositories are available without prescription.

Stimulant laxatives interfere with absorption and motility and are available without prescription. They have an onset of action of six to twelve hours and produce a soft to semi-fluid stool. They include saline laxatives (brand names milk of magnesia and citrate of magnesia); diphenylmethane derivatives (brand name dulcolax); and anthraquinone derivatives (senna, cascara sagrada and aloin).

Levsin etc. (hyoscyamine)


this is helpful in controlling conditions such as colitis, spastic bladder, diverticulitis, infant colic, renal and biliary colic, peptic ulcer, irritable bowel syndrome, splenic flexure syndrome, and pancreatitis. L-hyoscyamine produces many effects in the body, including relief from spasms of the gastrointestinal tract (stomach and intestines), the bladder, and the biliary tract.

There is no cure for ibs, but with a proper diet and some help from your doctor, symptoms can be made more manageable.

For more on treatment options, click here
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replied April 1st, 2006
Experienced User
Hi There. to the Women Who Posted On Here.
Hi there. I just wanted to let the women on here (who posted some of the same symptoms as i) and may think it is ibs--i was researching ibs and found that it sometimes gets misdiagnosed (when in reality the symptoms may have something to do with the ovaries). Not to scare anyone (just as research) if you look up symptoms of ibs and symptoms of ovarian cancer---they run along some very similar lines here. I didn't mention this before but my doctor had me do both the abdominal ct scan and the pelvic ct scan the same day (mine came back normal)--for the women on here--if you are having abdominal pains--doesn't hurt to have a pelvic ultrasound or a pelvic (ct scan) just to make sure that it is ibs and nothing more. Thanks.
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replied April 1st, 2006
Experienced User
Facts About Ovarian Cancer
The whisperings of ovarian cancer

by laura dolson

a year after his wife, gilda radner, died of ovarian cancer, gene wilder appeared on tv to alert women about the early warning signs of the disease. Later, he received a letter from a woman who had been watching. She wrote, "as you described gilda's symptoms, I felt a chill wash through my body, and I knew that i, too, had ovarian cancer".* she went on to say that she did indeed have cancer, but that it was caught in the earliest stage when the prognosis is very good.

Ovarian cancer has long been called "the silent killer", because it usually isn't discovered until its advanced stages. 70-75% of the time the cancer has spread to other parts of the abdomen before it is detected. However, there is something that can be done, now, to improve these dismal statistics. The truth is that some substantial portion of the time, early-stage ovarian cancer does produce symptoms - and the new battlecry of ovarian cancer activists is "it whispers - so listen!".

Unfortunately, this cry is still rarely heard outside of the community of people who have already been affected by the disease. Even now, in medical textbooks and articles, the fact that ovarian cancer often causes early symptoms is rarely mentioned. No wonder that women, on the whole, don't know what symptoms to be alert for. Why should this be? Among the reasons:

- it is unknown what percentage of early-stage ovarian cancer produces symptoms. The vast majority of women diagnosed with ovarian cancer do experience symptoms. However, since most of these women are diagnosed in more advanced stages, it's impossible to tell how many of them had symptoms before the cancer started to spread. It is known that 90% of women who are diagnosed in stage I come to their doctors with symptoms before diagnosis, and also that far too many cases of ovarian cancer take months to diagnose - a recent study showed that almost half took more than three months, and 11% took longer than a year. So it seems logical to assume that some substantial percentage of women do have early symptoms.

- the common symptoms are non-specific - usually caused by other things. The list below contains a number of possible symptoms of ovarian cancer. But these symptoms can also result from a wide variety of non-cancerous conditions. If a woman has trouble zipping up her jeans, she's more likely to blame middle-aged spread than ovarian cancer. Thankfully, a gas pain isn't ordinarily a dire signal. Still, if a woman suddenly starts experiencing any of the symptoms below, and they persist for more than a 2-3 weeks, she should get those symptoms checked out.

- there is no one "marker symptom". Although abdominal swelling/bloating is the most often-mentioned first symptom, some studies show that even this is true only for a minority of ovarian cancer cases. Because each symptom will affect only some women, it is vital that women educate themselves about the whole constellation of symptoms associated with ovarian cancer.

- denial. Of course, no one wants to think about cancer. But think about this: the lifetime risk of women worldwide for ovarian cancer is 1 in 70. In the u.S. It is 1 in 55. Think about your high school graduating class. Your church. Your workplace. The numbers of women you know. How many of them are likely to get ovarian cancer? Ovarian cancer is not rare.

Women must begin to educate themselves about this insidious disease.

Warning symptoms of ovarian cancer

contact your md if you develop one or more of these symptoms and they persist for 2-3 weeks:

-abdominal swelling/bloating/clothes too tight
-abdominal/pelvic pain or pressure or feeling "full"
-gastrointestinal symptoms (such as gas, indigestion, nausea, or changes in bowel movements)
-vaginal bleeding or discharge
-urinary problems - urgency, burning, or spasms
-fatigue and/or fever
-pain during intercourse
-back pain
-difficulty breathing

remember, the vast majority of the time, these will not be due to cancer, but you owe it to yourself to get them checked out.

What should you expect from your doctor at your appointment? In addition to testing for other causes for your symptoms, your doctor should perform a pelvic examination, including the rectovaginal component. A prompt pelvic exam has been shown to be one of the best predictors of timely diagnosis. The other non-invasive tests used to detect ovarian cancer are the ca-125 blood test, and transvaginal ultrasound. These three tests together will alert the doctor to whether there is a danger of ovarian cancer.

Save lives *** spread the word
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replied April 1st, 2006
Experienced User
More Info About Ovarian Cancer/tests to Screen It.
Though you probably don't know it, september is national ovarian cancer awareness month. As such, this is as good an opportunity as any to post a brief public service announcement so you can be vigilant about early ovarian cancer detection in yourself and your loved ones. As with most cancers, early detection is key to long-term survival.

The problem with early detection, however, is that the symptoms of ovarian cancer often mimic many truly benign or non life-threatening physical discomforts and ailments that most healthy women experience at some time or another in their lives. For that reason, ovarian cancer is referred to as "the disease that whispers," because its symptoms are often so "ordinary" that you have to listen very carefully to hear what they are saying. These symptoms include:

unexplained change in bowel and/or bladder habits, such as constipation, diarrhea, urinary frequency, and/or incontinence
gastrointestinal upset, such as gas, indigestion, and/or nausea
unexplained weight loss or weight gain
pelvic and/or abdominal pain or discomfort
pelvic and/or abdominal bloating or swelling
a constant feeling of fullness
abnormal postmenopausal bleeding
pain during intercourse
unusual fatigue
persistent lower back pain
as you can see, most of these symptoms are pretty mild, and they can be occasionally normal for many women. Therein, of course, is the rub -- and the danger.

In fact, it isn't uncommon for women to go undiagnosed or misdiagnosed for alarming periods of time after they initially present to their gynecologists or family physicians. In a lot of cases, it seems, women are paying attention to the whispers but their healthcare practitioners are not -- dismissing their symptoms as minor irritations, or pursuing fruitless or erroneous diagnostic paths.

Typically, women with ovarian cancer complain of gastrointestinal upset. After a standard pelvic exam that reveals nothing, they often end up getting a colonoscopy, which either turns up negative or leads to the misdiagnosis of a gastrointestinal disorder or disease, such as irritable bowel syndrome or, in my case, crohn's. Often, it isn't until months later that ovarian cancer is eventually diagnosed -- months in which their cancer has had more time to grow and metastasize.

If you experience any of the above symptoms for more than two or three weeks, head to your internist. First, make sure you demand that he or she does a rectovaginal exam rather than just a standard pelvic exam. In nearly all cases, standard pelvic exams, which are practiced routinely by most healthcare providers, cannot diagnose ovarian cancer. Rectovaginal exams, on the other hand, are effective diagnostic tools. You should, in fact, be requesting them during your annual visit to the gynecologist. As far as i'm concerned, it's shocking -- but not surprising -- that they aren't considered the standard of care.

When you see your doctor, you should also demand that he or she run a ca-125 screening. This simple blood test detects a protein made by abnormal ovarian cells and can aid in diagnosis. However, it is important to note that ca-125 readings are not foolproof; they can be elevated in healthy people and they can fall within the normal range in women with ovarian cancer.

As a result, it is critical that if you continue to experience symptoms you keep searching for answers. If you are sent to a gastroenterologist at some point and you are not diagnosed -- or if you suspect a misdiagnosis -- you must push harder. A pelvic ultrasound, ct scan, or pet scan would bet the next step.

Although the bottom line is that if you experience symptoms the liklihood is that you do not have ovarian cancer (only about 25,000 american women are diangosed annually), I cannot emphasize how important it is to demand that your healthcare provider address it as a possibility. This is doubly true if you are young because ovarian cancer typically afflicts post-menopausal women, so physicians are less likely to be looking for it in pre-menopausal women. It is even more imperative for women with a family history of breast and/or ovarian cancers.

Perhaps, in the four months leading up to my diagnosis, if my primary care physician had done a rectovaginal exam instead of a pelvic exam, or if my gastroenterologist, who was "certain" I had crohn's, hadn't dismissed my concerns that I felt something hard in my abdomen, I would have been diagnosed earlier -- giving me that much more of a chance at a cure.

Don't lose yours.
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replied April 2nd, 2006
Experienced User
Ovarian Cysts For Women Can Mask Some of Ibs Symptomsoverlap
What are the symptoms of ovarian cysts?
Many women have ovarian cysts without having any symptoms. Sometimes, though, a cyst will cause these problems:

pressure, fullness, or pain in the abdomen
dull ache in the lower back and thighs
problems passing urine completely
pain during sexual intercourse
weight gain
painful menstrual periods and abnormal bleeding
nausea or vomiting
breast tenderness
if you have these symptoms, get help right away:

pain with fever and vomiting
sudden, severe abdominal pain
faintness, dizziness, or weakness
rapid breathing





how are ovarian cysts found?
Since ovarian cysts may not cause symptoms, they are usually found during a routine pelvic exam. During this exam, your doctor is able to feel the swelling of the cyst on your ovary. Once a cyst is found, the doctor may perform an ultrasound, which uses sound waves to create images of the body. With an ultrasound, the doctor can see how the cyst is shaped; its size and location; and whether it’s fluid-filled, solid, or mixed. A pregnancy test is also done. Hormone levels (such as lh, fsh, estradiol, and testosterone) may also be checked. Your doctor may want to do other tests as well.

To find out if the cyst might be cancerous, your doctor may do a blood test to measure a substance in the blood called ca-125. The amount of this protein is higher if a woman has ovarian cancer. However, some ovarian cancers do not make enough ca-125 to be detected by the test. There are also non-cancerous diseases that increase the levels of ca-125, like uterine fibroids and endometriosis. These non-cancerous causes of increased ca-125 are more common in women under 35, while ovarian cancer is very uncommon in this age group. For this reason, the ca-125 test is recommended mostly for women over age 35, who are at high risk for the disease and have a cyst that is partially solid.

How are cysts treated?
Watchful waiting. The patient waits and gets re-examined in one to three months to see if the cyst has changed in size. This is a common treatment option for women who are in their childbearing years, have no symptoms, and have a fluid-filled cyst. It also might be an option for postmenopausal women.

Surgery. If the cyst doesn’t go away after several menstrual periods, has gotten larger, looks unusual on the ultrasound, causes pain, or you’re postmenopausal, the doctor may want to remove it. There are two main surgical procedures:

laparoscopy—if the cyst is small and looks benign on the ultrasound, your doctor may perform a laparoscopy. This procedure is done under general anesthesia. A very small incision is made above or below the navel, and a small instrument that acts like a telescope is inserted into the abdomen. If the cyst is small and looks benign, it can be removed.
Laparotomy—if the cyst is large and looks suspicious, the doctor may perform a procedure called a laparotomy. This procedure involves making bigger incisions in the stomach to remove the cyst. While you are under general anesthesia, the doctor is able to have the cyst tested to find out if the tissue is cancerous. If it is cancerous, the doctor may need to remove the ovary and other tissues that may be affected, like the uterus or lymph nodes.
Birth control pills. If you frequently develop cysts, your doctor may prescribe birth control pills to prevent you from ovulating. This will lower the chances of forming new cysts.

Can ovarian cysts be prevented?
Ovarian cysts cannot be prevented. Fortunately, the vast majority of cysts don’t cause any symptoms, are not related to cancer, and go away on their own. Talk to your doctor or nurse if you notice any changes in your period, pain in the pelvic area, or any of the major symptoms listed above. A pelvic exam, possibly with an ultrasound, can help determine if a cyst is causing the problem. If a woman is not seeking pregnancy and develops functional cysts, frequently, future cysts may be prevented by taking oral contraceptives, depo-provera, or norplant.

When are women most likely to have ovarian cysts?
Functional ovarian cysts usually occur during the childbearing years. Most often, cysts in women of this age group are not cancerous. Women who are past menopause (ages 50-70) with ovarian cysts have a higher risk of ovarian cancer. At any age, if you think you have a cyst, it’s important to tell your doctor.

For more information...
You can find out more about ovarian cysts by contacting the national women's health information center (nwhic) at 800-994-9662 or the following organizations:

agency for healthcare research & quality (ahrq), hhs
phone: (800) 358-9295
internet address: http://www.Ahrq.Gov

national institute of child health and human development (nichd), nih, hhs
phone: (800) 370-2943
internet address: http://www.Nichd.Nih.Gov/womenshealth

american academy of family physicians (aafp)
internet address: http://familydoctor.Org

american society for reproductive medicine (asrm)
phone: (205) 978-5000
internet address: http://www.Asrm.Org

international council on infertility information dissemination, inc. (inciid)
phone: (703) 379-9178
internet address: http://www.Inciid.Org
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replied April 2nd, 2006
Experienced User
Diverticulosis
Diverticulosis

this is a common condition, usually affecting the colon, in which small pockets of the mucosa lining the colon are pushed out to form small sacs called diverticula. These pockets most often occur in the sigmoid colon, and are very common over the age of 40. At the age of 60, more than two-thirds of americans have developed diverticulosis. The presence of these pouches is not in itself dangerous, but if the diverticula become infected or inflamed, diverticulitis results. This condition may be associated with perforation and/or bleeding, and may require strong antibiotics or surgery.

The cause of diverticulosis remains obscure, but genetic and dietary factors are felt to play a part. Populations consuming high fiber diets rarely get diverticulosis, and western diets with refined foods and low fiber content exhibit the highest rates of the condition in the world. Low fiber diets are also associated with chronic constipation, and this may lead to the observed abnormal thickening of the colonic wall which is seen adjacent to the diverticular sacs.

Prevention and treatment of diverticulosis is therefore mainly dietary. Bran cereal, fiber additives such as psyllium, and fresh fruits and vegetables, along with plenty of fluids, are recommended. Foods to avoid include popcorn, seeds, and nuts, which are more difficult to digest and may get trapped in diverticula leading to diverticulitis.

Irritable bowel syndrome

this condition is perhaps the most common disorder seen by the gastroenterologist. Ibs is a "functional" disorder, which means there is abnormal behavior of the intestine without any organic disease. The cause of ibs is unknown, but certain inciting factors are well established. Stress is the most common, leading to tightening and spasm in the intestinal muscles. Patients may feel cramps, bloating, urgency to defecate, nausea, or increased need to pass gas. In others, these symptoms may be precipitated by certain foods, especially dairy products, raw fruits and vegetables, or coffee. Women with ibs may have more symptoms in the week before menstruation and during menopause.

Ibs is a diagnosis of exclusion. All other conditions that may cause similar symptoms must be ruled out. Crohn’s disease, colitis, diverticulosis, and colon cancer at times present with symptoms similar to ibs. Patients may therefore require blood tests, stool analysis, and x-ray or endoscopic studies before a diagnosis of ibs can be assured.

Fortunately, ibs is not life-threatening. Treatment may require dietary adjustments, stress management, or antispasmodic medications.



Ulcerative colitis

ulcerative colitis and crohn’s disease make up the majority of cases of inflammatory bowel disease (ibd). Like crohn’s disease, ulcerative colitis is a chronic inflammatory condition of the bowel which often first occurs in childhood and young adulthood. Unlike crohn’s disease, ulcerative colitis only involves the colon, and typically is most severe in the rectum and less severe higher up in the large intestine. It is also a continuous inflammation, without normal areas of mucosa interspersed amid the disease. About 10% of patients will have one attack and then go into remission for decades, while another 10% will have unrelenting symptoms, some of them developing a toxic form of colitis requiring total proctocolectomy. The majority of patients, however, will have periods of remission and relapse over the years. Extraintestinal manifestations most often involve inflammation in joints, skin, bile ducts, and the eye. Diagnosis is made by colonoscopy with mucosal biopsies. Mild cases of ulcerative colitis, when localized only to the rectum, are referred to as proctitis and may be managed with administration of anti-inflammatory medicine in the form of an enema. More severe cases require oral anti-inflammatory or immunosuppressant therapy. The disease can be cured by removing the colon in cases not responsive to medical therapy. Chronic ulcerative colitis is a risk factor for colon cancer, with the risk directly proportional to the duration and extent of the disease. Surveillance colonscopies at regular intervals are therefore recommended for patients with ulcerative colitis for greater than 7 years and with disease which extends up to and above the splenic flexure.
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replied April 3rd, 2006
Experienced User
Ibs Information---treatment Approaches
Treatment of irritable bowel syndrome — there are a number of different treatments and therapies for ibs. Many of these measures can be combined to effectively reduce the pain and other symptoms of ibs. Because of the wide variability of symptoms in people with this condition, different treatments and therapies work for different people. Treatment is usually a long-term process; during this process, it is important to maintain good communication with your doctor about your symptoms, your concerns, and any psychologic and social issues that arise.

Monitoring — the first step in treating ibs may be close monitoring of your symptoms, your daily habits, and any other factors that may affect gastrointestinal function. This step can identify factors that worsen symptoms in some people with ibs, such as lactose or other food intolerances and stress. A daily diary can be helpful.

Dietary modification — as discussed above, people with ibs commonly describe food intolerances. Many have already eliminated or avoid certain foods known to aggravate their symptoms. The systematic elimination of particular foods can be helpful to determine the relationship between the food and symptoms. This strategy may be particularly useful in patients who have eliminated multiple foods, a behavior which in itself can contribute to the decreased quality of life experienced by many people with ibs.

Many doctors recommend the temporary elimination of dairy products, since lactose intolerance is common and can cause symptoms similar to ibs or aggravate ibs. People who avoid lactose should take dietary calcium supplements.

Several foods are only partially digested in the intestines. When they reach the colon, further digestion takes place by bacteria, which produce gas as a byproduct of their digestion. As a result, these foods can cause gas and cramps. The most common are the legumes (such as beans) and cruciferous vegetables (ie, vegetables that have a cross at their base) such as cabbage, brussels sprouts, cauliflower, and broccoli. In addition, some patients have trouble with onions, celery, carrots, raisins, bananas, apricots, prunes, sprouts, and wheat.

Increasing dietary fiber — increasing dietary fiber (either by adding certain foods to the diet or using fiber supplements) can relieve symptoms in some people with ibs, particularly people who have combined abdominal pain and constipation. It may also be helpful in people with diarrhea predominant symptoms since it can improve the consistency of stools. It is often helpful to take a dietary fiber supplement (such as psyllium [metamucil] or methylcellulose [citrucel]) since it is difficult to consume enough fiber in the diet, particularly when avoiding foods known to increase intestinal gas. Dietary fiber supplements should be increased to the prescribed dose over several weeks to help reduce the symptoms of excessive intestinal gas, which can occur in some people when beginning fiber therapy. The reasons that fiber helps people with ibs are not completely understood.

Psychosocial therapies — stress and anxiety can worsen ibs in some people. The best approach for reducing stress and anxiety depends upon the individual and the severity of symptoms. You should have an open discussion with your doctor about the possible role that stress and anxiety could be having on your symptoms, and together decide upon the best course of action for you.

Some patients benefit from formal counseling with or without pharmacologic therapy or other treatments such as hypnosis and biofeedback.
Participation in a support group can also be valuable.
Many patients find that daily exercise can be extremely helpful to their sense of well-being. Exercise can also have favorable effects on bowel action.
Drugs — although many drugs are available to treat the symptoms of ibs, these drugs do not cure the condition, and they are used primarily to support other types of treatment. The choice among these drugs depends in part upon whether a person has diarrhea, constipation, or pain predominant ibs. Furthermore, the effectiveness of specific drugs varies from one person to another. As a general rule, drugs are reserved for patients whose symptoms have not adequately responded to more conservative measures such as changes in diet and fiber supplementation.

Anticholinergic drugs — anticholinergic drugs block the nervous system's stimulation of the gastrointestinal tract and thus have an antispasmodic effect, relieving severe cramping and irregular contractions of the colon. Drugs in this category include dicyclomine (bentyl) and hyoscyamine (levsin). These drugs may be particularly helpful when taken prophylactically (ie, before symptoms) and thus are most helpful for patients who can predict the onset of their symptoms. Common side-effects include dry mouth and eyes and blurred vision.

Antidepressants — many antidepressants have a pain relieving effect that is independent of their depression relieving effect. The pain relieving effect can often be observed at doses that are too low to have an antidepressant effect. These drugs can alleviate the abdominal pain of ibs, although they typically require three to four weeks to take effect. One class of antidepressants, tricyclic antidepressants, which includes amitriptyline, imipramine, and nortriptyline, also slow movement of contents through the gastrointestinal tract and may be most helpful in people with diarrhea predominant ibs. Another class of antidepressants, the selective serotonin reuptake inhibitors, including the drugs paroxetine (paxil), fluoxetine (prozac), sertraline (zoloft), and citralopram (celexa), are usually prescribed for people who have both ibs and depression.

Antidiarrheal drugs — the drugs loperamide (imodium) or diphenoxylate with atropine (lomotil) can help slow the movement of contents through the gastrointestinal tract. Loperamide and diphenoxylate/atropine are most helpful in people with diarrhea predominant ibs. However, doctors usually recommend that these drugs should only be used as needed, and rarely on a continuous basis.

Anxiolytic drugs — anxiolytic drugs reduce anxiety. Diazepam (valium) belongs to this class of drugs. Anxiolytic drugs are occasionally prescribed for people with ibs who are experiencing acute anxiety that is worsening their symptoms. However, these drugs should only be taken for short periods of time since they interact with other drugs, and cause addiction and withdrawal syndromes.

Drugs affecting serotonin receptors — serotonin is a hormone that is involved in intestinal contractions and sensation. Drugs that stimulate the serotonin receptors increase intestinal contractions while drugs that block them decrease intestinal contractions.

The blocking category of these drugs is best suited for people with diarrhea-predominant symptoms. The first that received approval from the food and drug administration was alosetron (lotronex). Alosetron was withdrawn from the market soon after its introduction because of concerns related to its safety, but was later reintroduced under tight regulatory control. Whether other drugs in this class will prove to be safer remains to be determined.

Tegaserod (zelnorm) is the first of the stimulating category of drugs to be approved by the food and drug administration. In clinical trials, it appeared to be moderately effective for women with constipation-predominant symptoms.

Drugs in development — several new classes of medications for ibs are currently in development. Their efficacy and safety compared to other treatments that are already available remains to be determined.

Herbs and natural therapies — a number of herbal and natural therapies have been advocated for the treatment of ibs. Unfortunately, evidence supporting their benefit from scientifically conducted studies is lacking. It is important to appreciate that even though small studies exist that support a benefit of many of these therapies, the studies are either too small or have major flaws that make definitive conclusions impossible.

Peppermint oil — there is a small amount of evidence supporting a benefit for peppermint oil, although it is difficult to make definitive conclusions. Peppermint oil can cause or worsen heartburn.

Acidophilus — there is increasing interest in the possible beneficial effects of so called "healthy" bacteria in a variety of intestinal diseases including ibs. Whether supplements containing these bacteria (such as acidophilus with or without "fos" or lactobacillus) are of any benefit is unproven.

Chamomile tea — chamomile tea is of unproven benefit in ibs. Furthermore, chamomile can aggravate allergies in people who tend to be allergic. People allergic to the grass family can have an allergic reaction to chamomile as well.

Evening primrose oil — evening primrose oil, a supplement containing gamma linolenic acid, is of unproven benefit.

Fennel seeds — fennel seeds are of unproven benefit.

Wormwood — wormwood is of unproven benefit and may be unsafe. Wormwood oil can cause damage to the nervous system.

Comfrey — comfrey is of unproven benefit and can cause serious liver problems.

Prognosis — although ibs can produce substantial physical discomfort and emotional distress, studies show that most people with ibs do not develop serious long-term health conditions. Furthermore, the vast majority of patients learn to control their symptoms.

Over time, less than 5 percent of people originally diagnosed with ibs will be diagnosed with some other gastrointestinal condition, so it is important to work with your doctor to monitor your symptoms over time. Further testing might be required if your symptoms have changed. On the other hand, studies also show that ibs does not decrease life expectancy; people with ibs live just as long as people in the general population.

Where to get more information — your doctor is the best resource for finding out important information related to your particular case. Not all patients with ibs are alike, and it is important that your situation is evaluated by someone who knows you as a whole person.
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replied April 3rd, 2006
Experienced User
Ibs Tests.
Screening and diagnosis


a diagnosis of irritable bowel syndrome depends largely on a complete medical history and physical exam. Your doctor may also recommend conducting several tests, including stool studies to check for infection or malabsorption problems. Among the tests that you may undergo to rule out other causes for your symptoms are the following:

flexible sigmoidoscopy. This test examines the lower part of the colon (sigmoid) with a flexible, lighted tube (sigmoidoscope).
Colonoscopy. In some cases, your doctor may perform this diagnostic test, in which a small, flexible tube is used to examine the entire length of the colon.
Computerized tomography (ct) scan. Ct scans produce cross-sectional x-ray images of internal organs. Ct scans of your abdomen and pelvis may help your doctor rule out other causes of your symptoms.
Lactose intolerance tests. Lactase is an enzyme you need to digest the sugar found in dairy products. If you lack this enzyme, you may have problems similar to those caused by irritable bowel syndrome, including abdominal pain, gas and diarrhea. To find out if this is the cause of your symptoms, your doctor may order a breath test or ask you to exclude milk and milk products from your diet for several weeks.
Blood tests. Celiac disease (nontropical sprue) is sensitivity to wheat protein that also may cause symptoms like those of irritable bowel syndrome. Blood tests may help rule out that disorder.
Criteria for making a diagnosis
because there are usually no physical signs to definitively diagnose irritable bowel syndrome, diagnosis is often a process of elimination. To help in this process, researchers have developed diagnostic criteria, known as rome criteria, for ibs and other functional gastrointestinal disorders — conditions in which the bowel appears normal but doesn't function normally.

According to these criteria, you must have certain signs and symptoms before a doctor diagnoses irritable bowel syndrome. The most important are abdominal pain and diarrhea or constipation lasting at least 12 weeks, though they don't have to occur consecutively. You also need to have at least two of the following:

a change in the frequency or consistency of your stool. For example, you may change from having one normal, formed stool every day to three or more loose stools daily. Or you may have only one hard stool every three to four days.
Straining, urgency or a feeling that you can't empty your bowels completely.
Mucus in your stool.
Bloating or abdominal distension.

Complications


both diarrhea and constipation can aggravate hemorrhoids. In addition, signs and symptoms of irritable bowel syndrome can interfere with your work, your relationships with friends and family, and your ability to live your life to the fullest. At times, you may feel discouraged or depressed.


Treatment


because it's still not clear what causes irritable bowel syndrome, treatment focuses on the relief of symptoms so that you can live your life as fully and normally as possible.

In most cases, you can successfully control mild symptoms of irritable bowel syndrome by learning to manage stress and making changes in your diet and lifestyle. But if your problems are moderate or severe, you may need more help than lifestyle changes alone can offer. Your doctor may suggest:

fiber supplements. Taking fiber supplements such as psyllium (metamucil) or methylcellulose (citrucel) with fluids may help control constipation.
Anti-diarrheal medications. Over-the-counter medications such as loperamide (imodium) can help control diarrhea.
Eliminating high-gas foods. If you have significant bloating or are passing significant amounts of gas, your doctor may also ask you to cut out such items as carbonated beverages, salads, raw fruits and vegetables, cabbage, broccoli and cauliflower.
Anticholinergic medications. Some people need drugs that affect certain activities of the nervous system (anticholinergics) to relieve painful bowel spasms.
Antidepressant medications. If your symptoms include pain and depression, your doctor may recommend a tricyclic antidepressant or a selective serotonin reuptake inhibitor (ssri). These medications help relieve depression as well as inhibit the activity of neurons that control the intestines. For diarrhea and abdominal pain, your doctor may suggest tricyclic antidepressants, such as imipramine (tofranil) and amitriptyline. Side effects of these drugs include drowsiness and constipation. Ssris such as fluoxetine (prozac, sarafem) or paroxetine (paxil) may be helpful if you're depressed and have pain and constipation.
Counseling. If antidepressant medications don't work, you may have better results from counseling if stress tends to exacerbate your symptoms.
Drugs specifically for ibs
there are currently two drugs available to treat ibs: alosetron (lotronex) and tegaserod (zelnorm).

Alosetron. This drug is a nerve receptor antagonist that's supposed to relax the colon and slow the movement of waste through the lower bowel. But the drug was removed from the market just nine months after its approval when it was linked to at least four deaths and severe side effects in 197 people. In june 2002, the food and drug administration (fda) decided to allow alosetron to be sold again — with restrictions. The drug can be prescribed only by doctors enrolled in a special program and is intended for severe cases of diarrhea-predominant ibs in women who haven't responded to other treatments. Alosetron is not approved for use by men.
Tegaserod. For women who have ibs with constipation, the fda has approved the medication tegaserod (zelnorm). It's approved for short-term use in women and has not been shown to be effective for treating men with ibs. Tegaserod imitates the action of the neurotransmitter serotonin and helps to coordinate the nerves and muscles in the intestine. Some reports have suggested a risk of rare, dangerous side effects similar to those of alosetron, but the drug is still available.
Generally, alosetron and tegaserod should only be used if you have failed usual therapy for your ibs. Additionally, they should only be prescribed by a gastroenterologist with expertise in ibs because of the potential side effects.


Prevention


anyone can experience digestive upset from worry or anxiety. But if you have irritable bowel syndrome, stress-related problems such as abdominal pain and diarrhea tend to occur with greater frequency and intensity. Finding ways to deal with stress can be extremely helpful in preventing or alleviating symptoms:

counseling. In some cases, a health care professional such as a psychologist or psychiatrist can help you learn to reduce stress by looking at how you respond to events in your life and then working with you to modify or change that response.
Biofeedback. This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the feedback help of a machine. You're then taught how to produce these changes yourself. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.
Regular exercise, yoga, massage or meditation. These can all be effective ways to relieve stress. You can take classes in yoga and meditation or practice at home using books or tapes.
Progressive relaxation exercises. These help you relax muscles in your body, one by one. Start by tightening the muscles in your feet, then concentrate on slowly letting all of the tension go. Next, tighten and relax your calves. Continue until the muscles in your body, including those in your eyes and scalp, are completely relaxed.
Deep breathing. Most adults breathe from their chests. But you become calmer when you breathe from your diaphragm, the muscle that separates your chest from your abdomen. When you inhale, allow your belly to expand with air; when you exhale, your belly naturally contracts. Deep breathing can also help relax your abdominal muscles, which may lead to more-normal bowel activity.
Hypnosis. Hypnosis may reduce abdominal pain and bloating. A trained professional teaches you how to enter a relaxed state and then guides you as you imagine your intestinal muscles becoming smooth and calm.
Other techniques. Set aside at least 20 minutes a day for any activity you find relaxing — listening to music, reading, playing computer games or just soaking in a warm bath.

Self-care


in many cases, simple changes in your diet and lifestyle can provide relief from irritable bowel syndrome. Although your body may not respond immediately to these changes, your goal is to find long-term, not temporary, solutions:

experiment with fiber. When you have irritable bowel syndrome, fiber can be a mixed blessing. Although it helps reduce constipation, it can also make diarrhea, gas and cramping worse. The best approach is to gradually increase the amount of fiber in your diet over a period of weeks. Examples of foods that contain fiber are whole grains, fruits, vegetables and beans. If your signs and symptoms remain the same or worse, tell your doctor. You may also want to talk to a dietitian. If you take a fiber supplement, such metamucil or citrucel, be sure to introduce it gradually and drink plenty of water every day to minimize gas, bloating and constipation. If you find that taking fiber helps your ibs, use it on a regular basis for best results.
Avoid problem foods. If certain foods make your signs and symptoms worse, don't eat them. Common culprits include alcohol, chocolate, caffeinated beverages such as coffee and sodas, medications that contain caffeine, dairy products, and sugar-free sweeteners such as sorbitol or mannitol. For some people, fats such as butter and margarine or foods high in fat such as mayonnaise, nuts, cream, ice cream and red meat also may aggravate symptoms. Be careful that your diet doesn't become too restricted, though. If you need help, talk to a dietitian. Large meals also may make your symptoms worse.
Eat at regular times. Don't skip meals, and try to eat about the same time each day to help regulate bowel function. If you have diarrhea, you may find that eating small, frequent meals makes you feel better. But if you're constipated, eating larger amounts of high-fiber foods may help move food through your intestines.
Take care with dairy products. If you're lactose intolerant, try substituting yogurt for milk. Or use an enzyme product, such as lactaid, to help break down lactose. Consuming small amounts of milk products or combining them with other foods to slow digestion also may help. In some cases, though, you may need to eliminate dairy foods completely. If so, be sure to get enough protein, calcium and b vitamins from other sources.
Drink plenty of liquids. Try to drink plenty of fluids every day. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, and carbonated drinks can produce gas.
Exercise regularly. Exercise helps relieve depression and stress, stimulates normal contractions of your intestines and can help you feel better about yourself. If you've been inactive, start slowly and gradually increase the amount of time you exercise.
Use anti-diarrheal medications and laxatives with caution. If you try over-the-counter anti-diarrheal medications, such as imodium or kaopectate, use the lowest dose that helps. In the long run, these medications can cause problems if you don't use them appropriately. The same is true of laxatives. If you have any questions about them, check with your doctor.

Coping skills


living with irritable bowel syndrome presents daily challenges. It may be painful or embarrassing and can seriously affect the quality of your life. These suggestions may help you cope more easily:

learn as much about ibs as you can. Talk to your doctor, look for information on the internet from reputable sources such as the national institutes of health and major medical centers or medical schools, and read books and pamphlets. Being informed about your condition can help you take better charge of it.
Identify the factors that trigger ibs. This is a key step both in managing your condition and in helping you feel you have control of your life.
Seek out others with ibs. Talking to people who know what you're going through can be reassuring. Try internet chat rooms or ibs support groups in your community. Your doctor may be able to refer you to a support group, or you may find one through your local paper or on internet sites.

Complementary and alternative medicine


the following nontraditional therapies may help relieve symptoms of irritable bowel syndrome:

acupuncture. Researchers at the national institutes of health (nih) have found that acupuncture can provide relief from chronic pain. Although study results on the effects of acupuncture on symptoms of irritable bowel syndrome have been mixed, some people use acupuncture to help relax muscle spasms and improve bowel function.
Herbs. Peppermint is a natural antispasmodic that relaxes smooth muscles in the intestines. Study results haven't been consistently encouraging, but if you'd like to try peppermint be sure to use enteric-coated capsules. Peppermint may aggravate heartburn. Before taking any herbs, check with your doctor to be sure they won't interact or interfere with other medications you may be taking.
Probiotics. Probiotics are "good" bacteria that normally live in your intestines and are found in certain foods, such as yogurt, and in dietary supplements. It's been suggested that people with irritable bowel syndrome may not have enough good bacteria, and that adding probiotics to your diet may help ease your symptoms. Some studies have shown that probiotics can decrease ibs exacerbations. Not all studies on probiotics have had positive results, however.
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replied April 3rd, 2006
Experienced User
Hey There.
Lol...I hope I am not scaring everyone off this site with my many postings--i feel like I writing to a person of one now (me)--:( anyhow, I just wanted to inform people that I called my doctor's office today to see if I can get a prescription for bentyl (it is an antispasmodic type of drug). I'm a little iffy on the side effects but how many drugs out there have a lot of "out there" side effects that seem to make the actual symptom seem minor in comparison. I will be starting it tomorrow and will let all (if anyone is still on this site know how it works out). I may have to give it a week or two--just to see if it kicks in and helps this out---

i read up on ibs (and as you saw in my 20-30 postings on here)--posted it to save everyone the work--i don't have constipation (except twice) and never if rarely ever get the big d--ibs always seems to relate to the urgency of one---and having to always find the restroom--something which doesn't seem to fit what I am feeling. I'm only getting the pain under the left rib---muscle spasm type of pain around the abdomen/under the ribcage--that is what is personally making me feel uncomfortable but I just thought I would lay out the information on this site to see if others might relate to it or not.

The key here isn't self diagnosis. If you haven't had any medical tests done and have these symptoms, don't just assume it is ibs. Get an endoscopy, colonoscopy, abdominal/pelvic ct scan (blood work) done to rule out/eliminate anything potentially life threatening before diagnosing it as ibs. I went the westernized (and expensive-:( ) route of having medical tests done to rule out everything before coming to this diagnosis.

I also, from trying this after being diagnosed-notice that caffeine is a big culprit (especially coffee). I don't drink regular coffee (more like those little mocha frappacino's from the store) but I cut back on those and noticed that the symptoms don't flare up as much. I've also been incorporating more fiber in my diet (like for breakfast--i have yogurt or maybe some raisin bran). I think milk is an irritant--so I may go organic if it does. I'm also going to cut back on dairy, chocolate (which is killer because I love chocolate), carbs (which I also love especially pasta), and eat smaller meals throughout the day (instead of 3 meals--like breakfast, lunch, and dinner). I think it is also good to pay attention to how fast you are eating your meal (i know that can be hard during the day because a lot of what we do revolves around time schedules--but if that is the case--it doesn't hurt to try to eat smaller meals (portion yourself) instead of big meals and cut back on anything heavy, spicy, greasy, or fattening (basically fast food--probably isn't that great unless you make conscious decisions on what foods will work and what won't).

I've had this pain for over two and a half years---and had these tests done in between so I know that it will probably take me a while to see what will work best for me and my digestive system. I know part of me wants fast answers (just to deal with it and move on)--but instead of focusing, i'm just going to make conscious choices and incorporate that into my daily life. It might take a while for the body to adjust to it. Good luck to all on here. I'll keep you up to date on how the bentyl works out (good/bad)
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