Syl... Rome III Criteria for IBS
#352747 - 11/27/09 06:21 AM
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Windchimes
Reged: 09/05/09
Posts: 581
Loc: Northern California
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Truthfully, I find this information quite confusing as to clarity or making much sense. I would say that IBS is sometimes not the only condition operating in someone with IBS. These things deserve further exploration if appropriate fiber and balancing soluable and insoluable fiber properly does not help clear the symptoms (in my case, diarrhea), thus IBS-D.
My worst trigger is stress, and I'm fully aware of that. Even so, I'm making permanent changes in my diet. I wasn't absorbing what I was eating and even a multivitamin taken with water or tea raced right through me in an explosion. I went to liquid vitamins that can be absorbed in the mouth if one can tolerate the taste. I can, I just follow-up with a peppermint candy and then some tea.
My colonscopy was performed in November 2008. I did well, UNTIL the scope was being withdrawn and further air and inspection was being performed. My descending colon began to spasm with a vengence! The IV med was stepped up and I went back into 'twilight zone'.
When the procedure was complete, my gastroenterologist told me that I had spastic colon (IBS), though no tumors nor polyps were found. My colon (according to her) was healthy and very clean. I asked her what I could do about the spasms and the diarrhea, she told me to take OTC Imodium and step up my fiber. Thanks a lot!
There was nothing said about the differences between soluable and insoluable fiber, nor any written information provided. I thank God that I found Heather's books and have learned so much, and am still learning.
I have become to believe that I also have developed a glucose intolerance, and I will be paying attention to this as well.
Now, Syl, can you translate what this Rome III criteria actually means in the diagnosis of IBS? 
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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Check Heather's newsletter on Update to the Rome Criteria for Diagnosing IBS - Educate Yourself!
Glucose intolerance is unlikely primarily because glucose is the body's primary energy source. Heather states it this way "For glucose concerns, your body eventually breaks down all carbohydrates (simple and complex, and no matter what the source or how much/which type of fiber they contain) into glucose, as this is the only fuel the brain can use."
Your physician like may others must not have been aware of the American Gastroenterology Task Force report An Evidence-Based Systematic Review on the Management of Irritable Bowel Syndrome. It says in Section 2.7 on the effectiveness of dietary fiber, bulking agents, and laxatives in the management of irritable bowel syndrome that "Psyllium hydrophilic mucilloid (ispaghula husk) [soluble fiber] is moderately effective and can be given a conditional recommendation (Grade 2C). A single study reported improvement with calcium polycarbophil. Wheat bran or corn bran [insoluble fiber] is no more effective than placebo in the relief of global symptoms of IBS and cannot be recommended for routine use (Grade 2C)." The role of soluble vs insoluble fiber in managing IBS has been known for more than 15 years.
I believe that stress is a big trigger for all of us IBSers but there is little to show it is a cause.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Thanks, Syl, for your prompt response here. This is helpful.
I will say that stress IS a big trigger for me. Unlike those who run to frig or cupboards when feeling stressed, I am one who has absolutely no appetite at all. If I force myself to eat something solid, I'm in abdominal pain until the food explodes out the other end only partially digested. Yuk!
When feeling stressed, I am better off relaxing, listening to calm instrumental music, praying, meditating, and taking in liquids only... these days that being peppermint tea and hot chicken broth with some fresh ginger in it. I have found this works well for me until the crisis is over, and then I can eat again absent the physical miseries.
Thanks again for the further info. 
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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I realize that stress is not the cause of IBS, but is a definite trigger for many with this condition like many other known medical conditions.
This makes we wonder if adrenaline plays a role in gut responses, a trigger for symptoms? When we feel stressed, we do experience adrenaline surges. Some people feel heart palpitations, others like myself dash to the bathroom and have problems digesting food completely.
I'd like to hear your thoughts on this.
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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Adrenaline (epinephrine) and noradrenaline (norepinephrine) along with a variety of neurotransmitters and hormones play a role in the gut response. Under stress adrenaline along with a cascade of may other bioactive compounds in the body definitely affect the GI tract. Even non-IBSers experience GI discomfort under stress. The 'fight-or-flight' response exacerbates IBSers more likely because of altered GI motility and sensation.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Trigger? Cause? Same darn thing to me. I know what CAUSED (child sexual abuse) my IBS, you can call it what you like. Know what I mean. I know you do. We are on the same page here.  Cause and effect. Simple.
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A cause is the event that produced IBS in the first place.
A trigger is something that exacerbates or sets off a cascade of biological events that results in IBS symptoms. For example, caffeine and high fat are IBS triggers not causes of IBS.
It is very difficult to establish a causal relationship. It is relatively easy comparatively speaking to establish a trigger.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Sorry, I disagree totally. I know that the trauma CAUSED my IBS. I know that for a fact, without a shadow of a doubt. Pre-trauma, perfectly normal child. Post-trauma, IBS immediately following incident. So, don't tell me I don't know what caused this because I DO! Sorry, but I am tired of hearing there is no darn cause, when I know darn well there is, and I know what caused mine.
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Gerikat... What I have come to realize in my own life path is that anytime something stressful tugs on that same part of my brain that experienced a prior stressor, my intestines react. The cause seemingly started this (internalization, imploding... whatever the 'experts' call it!), but the end result is the very same!!!
I fortunately was never sexually abused, though my father was an alcoholic and dinnertime was always a stressful time for me. He physically abused my mother, and when mad at the dinner table would even go so far as to throw food against the wall and break dishes. I can see that my IBS started around age 5, and thus the reason why I cannot tolerate food when I feel stressed, just like I did back then as a child.
The cause and effect are to me OBVIOUSLY linked! Thank you for your input.
My very best to you and others in controlling the stress in their personal lives today as much as possible, and learning how to eat things that do not offend the original damage.
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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Syl, My dentist cannot even inject me with epinephrine when working on my teeth. I immediately get heart palpitations and start to shake! Feeling that way (out of physical control) makes things even worse. He now uses an alternative pain killer that does not produce the same response in me.
I definitely have a well-documented response to epinephrine that is physiological in nature, though might well be related to the psychological 'flight or fight' response that I had as a child when I would run to my bedroom and lock the door when my father was throwing one of his tantrums. I feared he might break the door down and physically abuse me, just as he did my mother.
I just don't handle adrenaline well at all today, whether it is injected or produced by my own bodily as a response to stress. Such immediately hits me right in the 'gut'. Adrenaline is adrenaline and I don't find such favorable to my end symptoms.
Thanks for the post.
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Senior female, IBS-D, presently stable thanks to Heather & Staff
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