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KinOz
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Reged: 02/02/03
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Posts: 909
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Loc: Brisbane, Australia
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Serotonin Info
#4647 - 03/31/03 02:29 PM
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Hi, I read with interest all the info that has been posted about Serotonin(spelling?) and its link to IBS.
I feel I can strongly relate to this as last year my doctor actually had me on an anti-depresssnt called fluoxetine and during that time I was symptom free and felt just fantastic so i do strongly beleive in that link.
Anti-D are not an option for me right now as I am going through IVF in the hopes of achieving a pregnancy. Also i didn't really want to be on drugs long term. i am hoping that the hypno tapes will have the same sort of effect on me though.
What do you all think? Kerrie
-------------------- What lies behind us and what lies before us are tiny matters compared to what lies within us.
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shawneric
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Reged: 01/30/03
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Posts: 1738
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Loc: Oregon
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Hi Kerrie, I think you are doing the right thing by trying this route, because its safe for one and may even as a side effect help the pregnancy when you have the baby, many use this just for that reason, not the IBS tapes but Hypnotherapy and I will find some articles on this for you.
The serotonin link and IBS has been confirmed, but there is still more they are working on. It is complex to say the least and I will slowly post information about it. 95 percent of it is created in the gut and there are two important cell receptors they know about in IBS. 5ht 3 and 5ht 4 receptors that line the digestive tract. It also plays a role in pain in IBS.
I will post info relevant to this and IBS for you, but have to warn you it takes a little while to learn all this and the implications in IBS.
Serotonin though is responsible for starting the Peristaltic Reflex or the start of gut contractions. It also plays a key role in communication between the gut and the brain.
However this is new even though they have been studying this for years. There seems to be a problem with the regulation of serotonin released from the gut and how it regulates/communicates from the gut to the brain and back to the gut.
"American College of Gastroenterology 67th Annual Scientific Meeting | IBS/ Functional Dyspepsia & Pancreatic Disease
New and Important Insights Into IBS: From Epidemiology to Treatment
"Pathophysiology
Altered Serotonin Signaling?
The pathogenesis of IBS remains obscure, and in particular, an explanation for alternating diarrhea and constipation has been elusive. In arguably one of the most important papers presented during this year's meeting, Moses and colleagues 21 studied potential deregulation of the gut's serotonin transporter in IBS.
It is known that serotonin 5-hydroxytryptamine or 5HT is released from enteroendocrine or enterochromaffin cells in response to either chemical or mechanical stimulation of the gut mucosa. Serotonin in turn initiates peristalsis, and then the serotonin released is taken up in health by a highly selective serotonin transporter SERT. One potential mechanism that could explain altered bowel function in IBS is an abnormality in the serotonin transporter itself. The study authors evaluated this hypothesis in patients with IBS with constipation and IBS with diarrhea compared with patients with ulcerative colitis and healthy controls. They were able to convincing show on blinded review that SERT immunoreactivity was less intense in patients with IBS with constipation and patients with ulcerative colitis.
If these findings are indeed correct, they represent a landmark observation. The findings suggest that patients with constipation and IBS may have a reduced capacity to reuptake serotonin, leading to excess free serotonin and then desensitization of these receptors, thus reducing motor function. In contrast, in the setting of diarrhea, serotonin uptake was normal. If the underlying abnormality in serotonin transporter function alternated, then this would in turn explain alternating constipation and diarrhea.
These data strongly suggest that IBS is a "real" gut disease and a potential diagnostic disease marker. They also suggest that it is valid to subdivide IBS into constipation and diarrhea symptom subgroups. This study also provides additional rationale for the use of serotonin-modulating agents in IBS and provides a new target for drug modulation. Confirmation of these very exciting initial findings in larger patient samples is awaited with great interest."
http://www.medscape.com/viewarticle/444514
The Brain Gut Axis
"Symptoms in IBS occur either because of abnormalities of intestinal motility or because of abnormalities of sensation - or through a combination of the two.
It is easy therefore to imagine how violent contractions or spasm of muscle surrounding the intestines can give rise to pain.
In normal people, distension of the gut will trigger nerve fibres lining the gut to transmit signals to higher centres in the brain that register pain. In IBS sufferers, it has been proved that pain is perceived at much lower levels of distension. This is known as the 'hypersensitive gut' or in scientific terms visceral hyperalgesia. It follows that abnormal motility or contractility of the intestines will lead to areas of distension that will react because of the hypersensitive gut and register the sensation of pain in the higher centres of the brain
A variety of features that affect function of the central nervous system or brain have now been shown to affect, by virtue of the connections of the brain gut axis, the events described above at the 'end organ' level. I.e. in the intestines."
http://www.ibs-research-update.org.uk/IBS/brain1ie4.html
This is worth reading and I will say mre about this all if you want?
The wisdom of the gut. Those butterflies in your stomach are not just in your mind.
http://www.ibsgroup.org/other/usnews000403.htm
Hope this helps some and two more for you.
The Use of Antidepressants in the Treatment of irritable Bowel Syndrome and Other Functional GI Disorders
http://www.med.unc.edu/medicine/fgidc/antidepressentsandibs.htm
Serotonin and IBS and the new IBS drugs.
http://www.aboutibs.org/Publications/serotonin.html
-------------------- My website on IBS is www.ibshealth.com
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Hi Kerrie,
I think trying the natural methods such as self-hypno are much better for you at this time, but do check with your doctor to get his/her input on it as well.... 
Best wishes, Evie
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KinOz
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Reged: 02/02/03
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Posts: 909
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Loc: Brisbane, Australia
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Shawneric, thankyou for the brilliant info. It is really interesting and helpful.. I would certainly be interested in any more info that comes up on this topic.
I am still planning to use the IBS Audio Program.
Kerrie
-------------------- What lies behind us and what lies before us are tiny matters compared to what lies within us.
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shawneric
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Reged: 01/30/03
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Posts: 1738
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Loc: Oregon
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Kinoz, I am glad it helped and I have a ton of it, some of it pretty complicated, but I will post it.
I am working today so I am short for time, but tomorrow I will post some more for you.
The IBS Audio Program is for the global symptoms of IBS and the problems associated with it and I will post some more on that also for you.
Glad it helps Kerrie.
-------------------- My website on IBS is www.ibshealth.com
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shawneric
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Reged: 01/30/03
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Posts: 1738
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Loc: Oregon
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Kinoz, this is about taking a natural 5ht supplement, but its more complicated then that and its not so much how much is in the body. Its a problem at the gut levels and cells in the gut. However this was a question someone asked on 5ht and IBS. But its good because it helps explain pressure sensitive cells in the gut that release serotonin and how the it all works.
Ask The Expert
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Image of a cadeusus
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General Medical Questions
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Q: I have suffered from irritable-bowel syndrome for many years. I get diarrhea. The doctors I've seen have offered little help. Recently, my daughter suggested I try an over-the-counter medicine called "5-Hydroxy-tryptophan," made by a company called Natrol Inc. My daughter says it is a mild antidepressant. It seems to have helped quite a bit, but it also seems to slow me down and make me feel tired. Can you give me any information on this? What is it, exactly, and are there any serious side effects? The only other medicine I take is Synthroid.
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The Trusted Source
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Harold J. DeMonaco, M.S.
Harold J. DeMonaco, M.S., is senior analyst, Innovative Diagnostics and Therapeutics, and the chair of the Human Research Committee at the Massachusetts General Hospital. He is author of over 20 publications in the pharmacy and medical literature and routinely reviews manuscript submissions for eight medical journals.
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June 19, 2001
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A:
Irritable bowel syndrome is now recognized as a disorder of serotonin activity. Serotonin is a neurotransmitter in the brain that regulates sleep, mood (depression, anxiety), aggression, appetite, temperature, sexual behavior and pain sensation. Serotonin also acts as a neurotransmitter in the gastrointestinal tract.
Excessive serotonin activity in the gastrointestinal system (enteric nervous system) is thought to cause the diarrhea of irritable-bowel syndrome. The enteric nervous system detects bowel distension (expansion) on the basis of pressure-sensitive cells in the bowel lumen (opening). Once activated, these pressure-sensitive cells promote the release of serotonin, which in turn promotes both secretory function and peristaltic function (the contractions of the intestines that force the contents outward). At least four serotonergic receptors have been identified to be participants in the secretory and peristaltic response.
Patients with diarrhea-predominant IBS may have higher levels of serotonin after eating than do people without the disorder. This recognition led to the development of the first drug used specifically to treat diarrheal symptoms of IBS, alosetron (also known as Lotronex). Alosetron blocked the specific serotonin receptors responsible for recognizing bowel distention. In doing so, it blocked the effects of serotonin and reduced both bowel secretions and peristalsis. Constipation was the most common side effect seen. (Note: Alosetron was removed from the market by the manufacturer after repeated reports of a dangerous condition known as ischemic colitis became known.) Tegaserod (Zelmac) is another drug under development and under review by the U.S. Food and Drug Administration for approval. Tegaserod is indicated for the treatment of constipation-predominant IBS and works to increase enteric nervous system serotonin activity.
So, increasing serotonin activity in the enteric nervous system produces increased bowel secretions and peristalsis (and potentially diarrhea), whereas depressing serotonin activity produces reduced secretions and reduce peristalsis (and potentially constipation). Increasing serotonin activity in the brain would increase awareness and, in higher doses, produce anxiety, insomnia and restlessness. So I would have expected exactly the opposite effects of those that you experienced.
I am unable to identify any possible drug interactions between 5-HTP and Synthroid (levothyroxine) but the symptoms described suggest a check with your doctor may be in order. Persistent feelings of tiredness and constipation may be signs of an underactive thyroid (hypothyroidism).
June 19, 2001
http://www.intelihealth.com/IH/ihtIH/WSIHW000/24479/8438/325205.html
Also it is worth reading this.
History of Functional Disorders
http://www.med.unc.edu/medicine/fgidc/historyfunctionaldisorders.htm
-------------------- My website on IBS is www.ibshealth.com
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KinOz
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Reged: 02/02/03
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Posts: 909
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Loc: Brisbane, Australia
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After all the info you have posted this may sound like a dumb question. I have read all the articles with great interest but it is a lot to take in and I'm still digesting it all - pardon the pun.
Seeing I suffer form IBS-C i assume my serotonin levels need to be raised? Are the hypnoitherapy tapes a natural way of doing this? Is that why your symptoms can improve?
I suffer so terribly from bloating. Today I think I will have to buy a new outfit to fit me it's so bad! I am really hoping the program will help with this symptom. I did read mike's FAQ's and it was listed as one of the things that can be hepled. Do you know anyone who has had a big improvement with bloating after using the program?
Thanks again,
I really enjoy reading all the info you post. kerrie
-------------------- What lies behind us and what lies before us are tiny matters compared to what lies within us.
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Hi Kerrie,
Quite possibly I wrote the book on "bloating"... IN fact it's one of my worst IBS Symptoms.
The clinical-specific IBS hypnotherapy has improved on that symptom, but not quite as significantly as it helped my D and C (I have alternating IBS).
For additional relief from the bloat, I've implemented a few simple dietary changes that work for me. However, dietary changes can be a very individual matter. You may want to check with Heather and see what delicious recipes she might recommend for the bloating.
I am having a bout with it tonight, as a matter of fact, and I know that it's due to stress... and it'll all work out in the end....... 
Take care, Evie
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shawneric
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Reged: 01/30/03
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Posts: 1738
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Loc: Oregon
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Hi Kerrie, sorry to here your in distress and thanks for your kind comments. On learning all this just go slow its very complex and take a while sometimmes reading the abstracts again and again, but in time it becomes easier and it is very benefical in the long run.
First HT has been shown to normalize bowel movemnts in IBS, how that works exactly is not understood yet, even though they do know some reasons, it seems to go deeper then they have been able to figure out yet.
Next, all kinds of things here though, one they don't totally understand bloating in IBS and are studying it more, not all of it is from gas however. Some of it might have to do with muscles and perrhaps a big part with diet, but there is much more to it then that even. Also like gas it a hard symptom to treat in IBS, however HT has been shown to reduce it and I will point you in the direction to read that and see a graph.
Here is some info and studies on it.
Aliment Pharmacol Ther 2002 Nov;16(11):1867-76 Related Articles, Links Click here to read Review article: bloating in functional bowel disorders.
Zar S, Benson MJ, Kumar D.
OGEM Department, St George's Hospital Medical School, London, UK.
Bloating is a frequently reported symptom in functional bowel disorders. It usually occurs in combination with other symptoms, but may also occur in isolation. The severity of bloating tends to worsen during the course of the day and improves overnight. Although frequently considered to be a subjective phenomenon, recent studies have shown that bloating is associated with a measurable increase in abdominal girth. The pathophysiology of bloating remains elusive, but the evidence supports a sensorimotor dysfunction of the bowel. The possible mechanisms include abnormal gas trapping, fluid retention, food intolerance and altered gut microbial flora. Further studies are needed to define the sensorimotor abnormalities associated with bloating, which might be segmental and transient rather than generalized and persistent. The lack of understanding of this symptom is paralleled by a limited availability of therapeutic options. Conventional medications used in functional bowel disorders are not helpful and may indeed worsen the symptoms. In future, new drugs with activity against serotonin and kappa receptors, or novel approaches such as the use of exclusion diets, probiotics and hypnotherapy, may prove to be useful.
Publication Types:
* Review * Review, Tutorial
PMID: 12390095
Air apparent: Studies of gas and bloating in IBS
http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0016508502688444&
Am J Gastroenterol 2001 Dec;96(12):3341-7 Related Articles, Links
Sensation of bloating and visible abdominal distension in patients with irritable bowel syndrome.
Chang L, Lee OY, Naliboff B, Schmulson M, Mayer EA.
CURE/Digestive Disease Research Center, University of California Los Angeles, Westwood 90024, USA.
OBJECTIVES: Abdominal bloating and distension are common symptoms of irritable bowel syndrome (IBS). The postulated pathophysiological mechanisms underlying these symptoms include increased production, retention, or perception of gas or luminal contents. The aims of this study were to prospectively compare the prevalence of, and clinical factors related to, bloating and distension in an IBS patient population. METHODS: A total of 714 consecutive patients who met Rome I criteria for IBS were prospectively surveyed, and were classified as having bloating alone (B) or bloating and distension (B+D) based on a comprehensive bowel symptom questionnaire. GI, extraintestinal, and psychological symptoms, as well as health-related quality of life measures were also assessed using validated survey instruments. RESULTS: A total of 542 IBS patients (76%) who reported abdominal bloating were studied. Of these, 132 patients fulfilled criteria for the B group, whereas 410 patients fulfilled criteria for the B+D group. There was a significantly different gender distribution in the B and B+D groups (female:male ratios, 1.4:1 and 2.8:1, respectively p < 0.02). There was also a significantly different bowel habit subgroup distribution, with a greater predominance of constipation in B+D group and of diarrhea in the B group (p < 0.03). Both groups were similar in other clinical parameters, including progressive worsening of symptoms during the day, and relief by passing stool or gas. Both bloating and distension worsened when other abdominal symptoms worsened. Abdominal distension was associated with greater symptom severity and less diurnal variation in symptoms, and was less often perceived as associated with food intake. CONCLUSIONS: Bloating and visible abdominal distension may arise from two distinct but interrelated physiological processes. Although the sensation of bloating may be related to enhanced sensitivity to visceral afferent stimulation, abdominal distension in more severely affected patients may be related to triggering of a visceromotor reflex affecting the tone of abdominal wall muscles.
PMID: 11774947
one more on bloating mechanisms. This is a good resource in general and worth looking over.
Gas and Bloating
http://gastroresource.com/GITextbook/En/chapter1/1-9.htm
On this page is a graph on bloating and HT. I personally still get bloated, but noot half as much as I use to and sometimes I do because I don't always eat perfectly in regards to my IBS, so sometimes yes I can trace it to foods, one other way also maybe from lack of eating right not just foods, but eating schedules and keeping the gut working and food in it.
Here is a graph of abdominal distension in IBS pre HT and after HT. This is also a public site from an expert worrth reading on HT for IBS.
http://www.ibshypnosis.com/IBSresearch.html
Home page
http://www.ibshypnosis.com/index.html
Hope this helps some and feel free to ask any question you want no question to me are dumb when it comes to IBS so know worries on that end. 
A probiotic may help this also.
because in IBS also there can be alter gut transit, it may trap gas in the colon and cause pain and bloating, by gaining better transit, it may cause you to fart, but it may also at the same time release gas pressure on the colon by expelling it, so this maybe one way HT helps this problem, although relaxing muscles and muscle tension probably helps as well and altering gut perception a part too.
The yoga may also help this and excersise as well also for better gut function and transit time. 
-------------------- My website on IBS is www.ibshealth.com
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shawneric
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Reged: 01/30/03
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Something else I thought of that may really help this and I have used effectively is Progressive Muscle Relaxation. If you do it give it a couple of weeks of doing it as benefits can increase with time, and it is probably good to talk to your doctor first about doing it, just to be safe.
But it can help all kinds of things in IBS and related symptoms, like headaches, back aches, and help perhpas as a preventitive measure in attacks happening for a variety of reasons.
http://www.noah-health.org/english/illness/mentalhealth/cornell/recovery/progmusc.html
-------------------- My website on IBS is www.ibshealth.com
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