Evidence from Germany on mucosal inflammation in IBS

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stepjrn
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Date Joined Jun 2010
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   Posted 8/20/2010 8:51 AM (GMT -7)   

shawn12
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   Posted 8/20/2010 9:38 AM (GMT -7)   
This isn't really new news. Its been know for about 5 or so years maybe even longer. Especially in Post infectious IBS studies.
 
This is just some more researchers confirming it, it seems.
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jeanneac
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Date Joined Feb 2009
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   Posted 8/21/2010 1:29 PM (GMT -7)   
thank you for that article. That was really good...!!!!

Well, it might be a surprise to some doctors who obviously dont' know much about IBS. LOL... I've run into some of them. It doesn't surprise me. I just wish they would have said what antihistamine they used. I have IBS and IBD. When one flares up, it gets the other one going. I have thought before that I've had relief when I had to take a benadryl. I may try it again at night and see what happens.

I remember when they thought stress caused ulcers until they found H. pylori. I had an aunt who died from stomach cancer from all the ulcers she used to get before they knew.

I just wish more docs were well informed about these diseases and didn't make us feel so bad when we pay our money for their crappy advice.
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, omeprazole for reflux.
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA.
Currently on flagyl and it is helping. Have apt with surgeon soon

shawn12
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   Posted 8/22/2010 11:51 AM (GMT -7)   
A couple things to know here. This inflammation is MACROSCOPIC of specific cells. Its embedded in the colon walls. You can see here how close they are to each other. The ec are major in starting the intestinal peristaltic reflex by releasing serotonin. This has been a recognized problem for many years now in IBS.
 
VIEW IMAGE
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I am not a doctor. All information I present is for educational purposes only and should not be subsituted for the advise of a qualified health care provider.

Please make sure you have your symptoms diagnosed by a medical practitioner or a doctor.

shawn12
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Date Joined Jul 2004
Total Posts : 1293
   Posted 8/22/2010 11:52 AM (GMT -7)   
also

Video Corner: Serotonin

Increasingly our understanding of IBS is that it is a heterogeneous disorder – that is, multiple factors contribute to the well defined symptoms of the disorder. One of these suspected underlying dysfunctions involves serotonin, which is a neurotransmitter or messenger to nerves. Most serotonin in the body is in cells that line the gut where it senses what is going on and through receptors signals nerves that stimulate a response. The serotonin must then be reabsorbed (a process called re-uptake) into cells. This process appears to be disrupted in people with IBS.

Serotonin and SERT
How does serotonin affect gut function? An interview with Gary M. Mawe, PhD, Professor of Anatomy and Neurobiology, University of Vermont, Burlington, VT. Dr. Mawe is a basic scientist.

http://www.aboutibs.org/site/learning-center/video-corner/serotonin
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I am not a doctor. All information I present is for educational purposes only and should not be subsituted for the advise of a qualified health care provider.

Please make sure you have your symptoms diagnosed by a medical practitioner or a doctor.

shawn12
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Date Joined Jul 2004
Total Posts : 1293
   Posted 8/22/2010 12:00 PM (GMT -7)   
However, inflammation cannot be a biomarker in IBS because it doesn't always cause pain. All people with active celiac have inflammation, but not all of them have pain or discomfort.

The brain seems to be amplifying the signals from the gut. So normal digestion and sensations can set off the symptoms.

Its pretty important to understand IBS is not just a gut problem, but now recognized as a brain gut axis disorder.



Think Twice: How the Gut's "Second Brain" Influences Mood and Well-Being
The emerging and surprising view of how the enteric nervous system in our bellies goes far beyond just processing the food we eat

http://www.scientificamerican.com/article.cfm?id=gut-second-brain


This is from the research group who just released the brain scans. This is very important.
The Neurobiology of Stress and Emotions

"We often hear the term "stress" associated with functional gastrointestinal (GI) disorders, such as irritable bowel syndrome (IBS). Many patients experience a worsening of symptoms during times of severely stressful life events. But what is stress? How often does it occur? How does our body respond to stress? This article explores the mechanisms that link stress and emotions to responses that have evolved to ensure survival and that, in the modern world, affect health—including gastrointestinal function. "

http://www.ibs.med.ucla.edu/Articles/PatientArticle003.htm
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I am not a doctor. All information I present is for educational purposes only and should not be subsituted for the advise of a qualified health care provider.

Please make sure you have your symptoms diagnosed by a medical practitioner or a doctor.

shawn12
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Date Joined Jul 2004
Total Posts : 1293
   Posted 8/22/2010 5:42 PM (GMT -7)   
This is important especially dr woods comments o perceieved stress or real stressors and mast cells that release histimine onto the smooth muscle of the colon.
 
FYI

Dr Drossman's comments on foods for IBS Health.

Shawn,
To say that people with IBS may get symptoms from food intolerances is an acceptable possibility, since the gut will over react to stressors of all types including food (high fat or large volumes of food in particular). Futhermore, there can be specific intolerances. So if you have a lactose intolerance for example, it can exacerbate, or even mimic IBS. Other examples of food substances causing diarrhea would be high consumers of caffeine or alcohol which can stimulate intestinal secretion or with the latter, pull water into the bowel (osmotic diarrhea). The same would be true for overdoing certain poorly absorbed sugars that can cause an osmotic type of diarrhea Sorbitol, found in sugarless gum and sugar substituted foods can also produce such an osmotic diarrhea. Even more naturally, people who consume a large amount of fruits, juices or other processed foods enriched with fructose, can get diarrhea because it is not as easily absorbed by the bowel and goes to the colon where it pulls in water. So if you have IBS, all of these food items would make it worse.

However, it is important to separate factors that worsen IBS (e.g., foods as above, stress, hormonal changes, etc.) from the cause or pathophysiology of IBS. Just like stress doesn't cause IBS, (though it can make it worse), foods must be understood as aggravating rather than etiological in nature.

The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.
Doug

http://www.ibshealth...ibs_foods_2.htm

http://www.ibshealth...bsfoodsinfo.htm

Dr Wood's comments for me


"Dr. Jack Wood, a renowned physiologist at The Ohio State University calls the ENS the little-brain-in-the-gut.

"Dear Shawn:

Sorry for the delayed reply to your question. I generally agree with Dr. Drosssman's response. A subgroup of individuals when they become sensitized to specific molecules in certain foods respond to ingestion of the molecules with symptoms of cramping abdominal pain, fecal urgency and explosive watery diarrhea. These are also the primary symptoms of diarrhea-predominant IBS. Enteric mast cells, by mechanisms we don't understand, become sensitized to the food molecule and respond to its presence by releasing a signal to the brain-in-the-gut (ENS) which is interpreted as a threat. The ENS responds by running a program which organizes secretion and motility into a behavior pattern of the bowel, which rapidly clears the threat from the lumen. Because to be effective secretion occurs in large volumes and the contractions that accomplish rapid propulsion are strong, running of the program has the side effects of diarrhea and cramping pain. Big brain input to mast cells during stress activates the mast cells to evoke the symptoms resulting from exposure of the mast cells to sensitizing food antigens. Aside from food allergens and mast cells, certain chemicals such as those in hot peppers, stimulate sensory nerves in the ENS and we are beginning to understand how this can also lead to food-related symptoms that might mimic or exacerbate IBS.

Hope this helps,

Jackie (Jack) D. Wood "

You have two brains: one in your head and another in your gut. Dr. Jackie D. Wood is a renowned physiologist at The Ohio State University. He calls the second brain, "the-little-brain-in-the-gut." This enteric nervous system is part of the autonomic nervous system and contains over one hundred million neurons, which is as many as are in the spinal cord. This complex network of nerves lines the walls of the digestive tract form the esophagus all the way down to the colon. This little brain in the gut is connected to the big brain by the vagus nerves, bundles of nerve fibers running from the GI tract to the head. All neurotransmitters, such as serotonin that are found in the brain are also present in the gut.

Dr Wood has discovered that this little-brain-in-the-gut has programs that are designed for our protection and which are very much like computer programs. They respond to perceived threats in the same way that the limbic system or the emotional brain does. So the threat of a gastrointestinal infection can activate the program that increases gut contractions in order to get rid of the infection. The symptoms are abdominal cramping and diarrhea.

Dr. Wood has determined that a type of cell found in the body and the gut, called the mast cell, is a key to understanding the connection of the big brain in the head with the little-brain-in-the-gut. Mast cells are involved in defense of the body. In response to certain threats or triggers, such as pollen or infection, mast cells release chemicals, such as histamine, that help to fight off the invader. Histamine is one of the chemicals that causes the symptoms of an allergy or a cold. When an infection of the gut occurs, such as food poisoning or gastroenteritis, the mast cells of the gut release histamine. The little-brain-in-the-gut interprets the mast cell signal of histamine release as a threat and calls up a protective program designed to remove the threat  at the expense of symptoms: abdominal pain and diarrhea.

The brain to mast cell connection has a direct clinical relevance for irritable bowel syndrome and other functional gastrointestinal syndromes. It implies a mechanism for linking allostasis and the good stress response to irritable states (e.g., abdominal pain and diarrhea) of the gut. Mast cells can be activated to release histamine in response to perceived psychological stress, whether the stressor or trigger is consciously perceived or not. So the end result is the same as if an infection activated the program in the-little-brain-in-the-gut: abdominal pain and diarrhea."

 

This is one reason why the thought of going for a long car ride or not being next to a bathroom or "worry" or "fear" can trigger IBS.

 

 

 

 

 



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I am not a doctor. All information I present is for educational purposes only and should not be subsituted for the advise of a qualified health care provider.

Please make sure you have your symptoms diagnosed by a medical practitioner or a doctor.

Yu Ming
New Member


Date Joined Sep 2010
Total Posts : 12
   Posted 9/1/2010 11:20 PM (GMT -7)   
"A subgroup of individuals when they become sensitized to specific molecules in certain foods respond to ingestion of the molecules with symptoms of cramping abdominal pain, fecal urgency and explosive watery diarrhea. These are also the primary symptoms of diarrhea-predominant IBS. Enteric mast cells, by mechanisms we don't understand, become sensitized to the food molecule and respond to its presence by releasing a signal to the brain-in-the-gut (ENS) which is interpreted as a threat. The ENS responds by running a program which organizes secretion and motility into a behavior pattern of the bowel, which rapidly clears the threat from the lumen. Because to be effective secretion occurs in large volumes and the contractions that accomplish rapid propulsion are strong, running of the program has the side effects of diarrhea and cramping pain."
 
wow this single post helped me make sense of what is happening to me. I usually have mild dull pain but when I consume fried food, I get acute pain which is relieved by a very bad diarrhoea shortly after. My conditions seem to fit. My bowels are sensitized to the fried food molecule which is interpreted as a threat and quickly removed through bowel movement causing a diarrhoea.
 
So does it mean if i take antihistamine I can prevent the ENS from running the "program". And can anyone tell what exactly is actually causing the dull pains? Is it the bloating that causes the sensitive bowel to expand and cause pain? Because I easily get dull pain to almost anything I eat.

shawn12
Veteran Member


Date Joined Jul 2004
Total Posts : 1293
   Posted 9/2/2010 3:54 PM (GMT -7)   
Actually Yu Ming, it might be the fat content triggering an alter gastro colonic responce to eating. This responce is exaggerated in IBSers, so the "act of eating can trigger the symptoms.

Foods themselves don't cause IBS, but can be triggers for a lot of reasons. But symptoms right after you eat something can be due to the "act of eating and an altered gastro responce. I will post how this works.

Heather from help for ibs wrote a good article on this.

http://www.helpforibs.com/footer/gastrocolic.asp

Gut 2001;48:20-27 doi:10.1136/gut.48.1.20
Irritable bowel syndrome
An exaggerated sensory component of the gastrocolonic response in patients with irritable bowel syndrome
M Simrén, H Abrahamsson, E S Björnsson
+ Author Affiliations

Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
M Simrén, Section of Gastroenterology, Department of Internal Medicine, Sahlgrenska University Hospital, S-41345 Göteborg, Sweden.magnus.simren@medicine.gu.se
Accepted 18 July 2000
Abstract
BACKGROUND/AIMS Visceral hypersensitivity is a feature of the irritable bowel syndrome (IBS). Postprandial symptoms are common in these patients. The effects of nutrients on colonic perception in IBS are incompletely understood.

SUBJECTS We studied 13 healthy subjects and 16 patients with IBS—eight had diarrhoea predominant (IBS-D) and eight constipation predominant (IBS-C) IBS.

METHODS Colonic perception thresholds to balloon distension and viscerosomatic referral pattern were assessed before and after duodenal infusion of lipid or saline, respectively. At the end of the infusions, plasma levels of gastrointestinal peptides were determined.

RESULTS Lipids lowered the thresholds for first sensation, gas, discomfort, and pain in the IBS group but only for gas in the control group. The percent reduction in thresholds for gas and pain after lipids was greater in the IBS and IBS-D groups but not in the IBS-C group compared with controls. IBS patients had an increased area of referred discomfort and pain after lipids compared with before infusion whereas the referral area remained unchanged in controls. No group differences in colonic tone or compliance were observed. In both groups higher levels of cholecystokinin, pancreatic polypeptide, peptide YY, vasoactive intestinal polypeptide, and neuropeptide Y were seen after lipids. Motilin levels were higher in patients and differences in the subgroups were observed. Levels of corticotrophin releasing factor were lower in the constipated group than in the diarrhoea group.

CONCLUSIONS Postprandial symptoms in IBS patients may be explained in part by a nutrient dependent exaggerated sensory component of the gastrocolonic response.

http://gut.bmj.com/content/48/1/20.abstract


"Postprandial abdominal discomfort may be attributed to an exaggerated gastro-colonic reflex (the colonic contractile response to a meal), the presence of colonic high amplitude-propagated contractions, increased intestinal sensitivity (visceral hyperalgesia), or a combination of these. Fat ingestion may exaggerate hypersensitivity."

http://www.merck.com/mmpe/sec02/ch021666/ch021666a.html

They have known this for quite sometime. People attribute it sometimes to specific foods, but its another issue altogether. Fats are the higher contributer to it.
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I am not a doctor. All information I present is for educational purposes only and should not be subsituted for the advise of a qualified health care provider.

Please make sure you have your symptoms diagnosed by a medical practitioner or a doctor.
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