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Re: Anxiety and IBS new
      #121514 - 11/13/04 02:02 PM
shawneric

Reged: 01/30/03
Posts: 1738
Loc: Oregon

The nervous system as a whole is divided into two parts.


The Central Nervous System and the Peripheral Nervous System.

The central nervous system is the brain and the spinal cord.

The Peripheral Nervous system.

The peripheral nervous system is divided into two major parts: the somatic nervous system and the autonomic nervous system.

1. Somatic Nervous System
The somatic nervous system consists of peripheral nerve fibers that send sensory information to the central nervous system AND motor nerve fibers that project to skeletal muscle.

2. Autonomic Nervous System
The autonomic nervous system is divided into three parts: the sympathetic nervous system, the parasympathetic nervous system and the enteric nervous system. The autonomic nervous system controls smooth muscle of the viscera (internal organs) and glands.


Okay so the "brain in the gut" is called the enteric nervous system. This system runs autonomically under the control of the autonomic nervous system. You don't have to conciously think about digesting your food, its done autonomically, like breathing and heart rate, etc., because these systems are under control of the autonomic nervous system.

I will come back to this a little more later, because there are important implications here and IBS.

But

"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."

So when the bowel is distended, it releases serotonin to start contractions. However, it is also major in sending information about sensations in the gut to the brain.


Stomach Noises.

"
Sarah, a 21 year old student, who was diagnosed with IBS, tell the story of her struggle with the condition.

The wrong lesson I taught myself in the lecture room

It was almost 11 o'clock on a Monday morning of March 1994. I was on my way to a Research Methods lecture, totally unaware that my first encounter with IBS lay shortly ahead.

Probably the only clue was this odd feeling in my stomach; it was this hollow kind of nausea & a really strange, uncomfortable sensation that I had never experienced before. It made me feel uneasy. Thinking that it would pass, I decided that I would go ahead and sit through the lecture. But within a few minutes, I was left wishing I had never entered the room.

Shortly after the lecture began, my stomach started making strange, loud noises. Wind was pioneering up and down my stomach like a rollercoaster, but far more critically for me, people could actually hear it doing so. Somebody sniggered behind me. And from that moment on, all I registered was humiliation. I felt trapped, out of control and totally isolated. With each noise that my stomach made, I became more and more terrified. Eventually, when I felt I could cope no longer, I left the lecture room."

http://www.surgerydoor.co.uk/livingwith/detail2.asp?level1=Living%20with%20Irritable%20Bowel%20Syndrome&level2=Case%20Study


Has not been much responce to this thread, but am going to keep the information flowing on all this, because its all part of IBS.

The autonomic nervous system.

"To summarize:

Thoughts and even subtle emotions influence the activity and balance of the autonomic nervous system (ANS).

The ANS interacts with our digestive, cardiovascular,immune and hormonal systems and is therefore ideally suited to translate mind states into organ functions/dysfunctions
Negative reactions create disorder and imbalance in the ANS.
Positive feelings such as appreciation and a state of relaxation create increased order and balance in the ANS, resulting in increased hormonal and immune system balance and more efficient brain function.
It has been shown in a number of studies that during mental or emotional stress and physical stress, there is an increase in sympathetic activity and a decrease in parasympathetic activity. This results in increased strain on the heart as well as on the immune and hormonal systems. Increased sympathetic activity is associated with a lower ventricular fibrillation threshold and an increased risk of fibrillation, in contrast to increased parasympathetic activity, which protects the heart."

http://www.cns.med.ucla.edu/Articles/PatientArticleSm02ANS.htm



"How does stress affect gastrointestinal problems?
A person with a gastrointestinal disease or disorder is vulnerable to the effects of anxiety specifically in the area of their existing illness. Stress may also increase the experience of pain, aggravate the disease process, and interfere with healing. We should note that research has not shown emotional stress to cause structural problems in the gastrointestinal system, however, one study has found changes to the bowel mucosal lining in people who had experienced many stressful events during the preceding year. While stress does not causes gastrointestinal problems, it can make existing conditions worse.

As mentioned, our bodies respond to sudden crisis situations by going into the fight-or-flight state - sometimes called a red alert state - in which we are ready to take action to deal with a potential threat. Physical changes of this response also include a shift of blood flow away from the digestive system in addition to the increased muscle tension and immune system suppression. It is these changes that are significant to people with gastrointestinal conditions.

An individual who is not able to handle difficult situations effectively may perpetually remain in the red alert state. The body is being maintained in an over-activated condition, thus disrupting the body's normal operation, including that of the digestive system. "

http://www.badgut.com/index.php?contentFile=stress_management&title=Stress%20Management


This study was very important and more studies have been done since then. It is one of the inlfammatory cells seen in IBS that can contribute to pain and is connected to irritable bladder and food sensitivies and histimine as well as why some people develop IBS after an enteric infection, from a bacteria, parasite and now maybe possible a virual infection in the gut.


and why I am in part posting this thread and how strongly I believe the importance of it all is in brain gut axis dysregulations.

FYI
Diagnosis, Pathophysiology, and Treatment of Irritable Bowel Syndrome

"Pathophysiology of IBS
The pathophysiology of IBS is a work in progress. Roughly 200 years after its initial description by the English physician William Powell, our understanding of what causes IBS symptoms remains incompletely understood. For most of the second half of the 20th century, tremendous attention was paid to the concept of altered gut motility as a cause of IBS symptoms.20 However, several difficulties are apparent in this approach. First, although altered motility of the colon and small bowel can be demonstrated in patients with IBS, there is a very poor correlation between IBS symptomatology and the presence of alterations in gastrointestinal motility. 21 Likewise, drugs that alter gastrointestinal motility alone, such as antispasmodic22,23 and prokinetic drugs like metoclopramide and cisapride,24,25 have not been shown to be of any significant benefit in relieving IBS symptoms.
The third dilemma facing investigators in this area is that no pathognomonic pattern of gut dysmotility can be identified specifically with IBS, as opposed to other functional or organic disorders of the gut.20 Altered motility, as occurs in IBS, is currently seen as one of many epiphenomena associated with the disorder, as opposed to being a cause of the disorder itself.
In the early 1980s, it was discovered that upon balloon distention in the rectum, individuals suffering from IBS were more sensitive to distention than were individuals who did not suffer from IBS.26 This means that IBS patients feel discomfort at lower levels of balloon inflation in the rectum and lower bowel than do normal controls. This finding has been replicated in numerous studies, and the concept of "visceral" hypersensitivity has been established.27 A second level of investigation in this area is the fascinating finding that individuals with IBS not only have a unique local response (in the rectum) to visceral stimulation, but they also tend to process signals in the brain differently from non-IBS controls. Mertz and others[27] have shown that IBS patients have differential responses in the anterior cingulate cortex and other areas of the brain when stimulated with rectal or sigmoid colon distention, compared with controls. These findings have been replicated by other investigators.28 These data certainly suggest the possibility of a "brain-gut axis" where peripheral symptoms are processed in the end organ (ie, the colon), and then neural signals are carried via visceral afferents to the spinal cord, and then to the brain, where they are subject to additional processing. 29 It is this brain-gut axis that has received considerable attention recently in IBS research. The findings of enhanced visceral sensitivity in the colon and rectum, as well as altered processing of signals in the brain, have provided new insight. Regarding the pathophysiology of IBS, the altered processing of neural sensation in IBS patients logically raises the question as to which neurotransmitters play a role in this abnormal signal transmission."

http://www.cfids-cab.org/cfs-inform/Ibs/ibs.medscape03.htm



--------------------
My website on IBS is www.ibshealth.com


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Re: Anxiety and IBS new
      #121527 - 11/13/04 03:05 PM
daliatree

Reged: 07/10/04
Posts: 1176
Loc: Manhattan, New York

I have had the fear since I was a little girl too and would run away just like your daughter...I still shake and cry and am a grown up. Its a feeling of sheer terror!! I hope your daughter manages to get over it!

--------------------
Feel the fear and do it anyway!


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Thank you so much! new
      #121531 - 11/13/04 03:36 PM
daliatree

Reged: 07/10/04
Posts: 1176
Loc: Manhattan, New York

This is all so fascinating...thank you !

--------------------
Feel the fear and do it anyway!


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Re: Thank you so much! new
      #121537 - 11/13/04 04:13 PM
prtyblueeyz

Reged: 12/19/03
Posts: 44
Loc: USA Michigan

There are no words to express how relieved I am once again to see I am not the only one. I thought my fear of puking was just my personality and some sort of thing I made up in my head. I started having issues with it when my sister was diognosed with cancer back when I was 11 and even after she passed away just to hear people get sick would make me cry. I then became very good friends with some one who has been an alcoholic since we were very young and all the puking would just make me so freaked out. I never ever knew there was a technical term for this phobia and now that I know I plan on studying this and looking into ways of getting help. I did not think there was a way to get past this being that I thought it was all in my head. This site is what gave me back my life, gave me a reason to go on, just when I really thought I was going to just say to heck with it and end it all I found this site and found out I was not alone. Now once again I have found that I am not alone again and this is just as important to me.
When my kids get sick I can not care for them, I cry as soon as I know some one has come down with the flu. My better half bowls on a league and I can not go because it's winter and there are germs, I freak out to the point where I use my sleeve to touch door knobs and I keep antibacterail hand wash with me.
I can only say thank you so much for showing me once again that I am not crazy and I am not alone!!!!!!

Jennifer

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Re: Anxiety and IBS new
      #121538 - 11/13/04 04:22 PM
prtyblueeyz

Reged: 12/19/03
Posts: 44
Loc: USA Michigan

http://www.emetophobia.org/forum/forum_posts.asp?TID=526&PN=1 This is a site all about the phobia, not sure if it will help but I am in the process of reading as much as I can.

Take care
Jenn

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This has opened my eyes... new
      #121544 - 11/13/04 05:06 PM
Nelly

Reged: 08/06/04
Posts: 4381
Loc: Within stray mortar fire of DC

I am reading these fear of puking posts wide-eyed. I had never heard of this before, and it sounds very real and very shared among a lot of people on this board. I have always thought as vomiting as relief. It's always been a comfort to me, and a sign that I am getting better.

I do not doubt for a second that for you vomiting can be extremely frightening to go through and very disturbing to watch. It's amazing, really, that fear of vomiting had never occured to me! My bf recently saw me have a major attack of D (fever, sweating, painful screaming, praying to die, etc.), and it really shook him and Freaked Him Out. He is now nervous of developing lactose intolerance and perhaps IBS, and no longer has any doubt IBS is real, and admits to me he is scared of such an attack happening to him.

Knowledge is power! This forum has once again served to enlighten and comfort!!!! All hail the forum!

Peace,

~nelly~

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Re: Anxiety and IBS new
      #121550 - 11/13/04 05:40 PM
Lefty1

Reged: 08/09/04
Posts: 157


I wish I would have known about this sooner. I feel like I have not been as sympethetic as I could have been. I am so sorry that you, my daughter and others are afraid. I really will post if I learn anything from her Dr. that might add to this discussion. I am going to have to read all the info. on this thread.

Hear is to good health!!!
Lefty


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Re: Anxiety and IBS new
      #121551 - 11/13/04 05:47 PM
Amari

Reged: 10/29/04
Posts: 36


You are so right!! You hit the nail on the head. I too went to the doctors with my symptoms of always feeling sick etc. And the doctors told me it was anxiety and stress. I believed it eventually for 3years, was put on medication, had a breakdown because I thought that I was crazy and it wasn't getting any better, until I was finally diagnosied correctly with IBS and also CFS. It took a while to get off the medication, my hair was failing out and I had to cut it off, and I didn't start out with anxiety but after 3 years of believing it, you give yourself anxiety. I know get a little bit anxious and a rare panic attack. With me having nausea alot has made me emetophobic although I am learning not to get so scared and worried about it, still hard!!
You have hit the nail right on the head, I think there is many of us out there!....Take Care Amari

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Brittany.... i'm just like you new
      #121554 - 11/13/04 05:57 PM
Amari

Reged: 10/29/04
Posts: 36


Hey Brittany, I too sleep with a bucket next to the bed, just in case. When ever I go somewhere first thing is I always look to see where a bin or the toliet is, just in case. I too aviod going anywhere if feeling sick, just in case of not being home when I am feeling sick. I think they can say that it is sort of a social emetophobia. I also when I go to the movies or shows, sit on the aisle and next to an exit, incase I need to escape...It can be such a head-ache most of the time....Take Care....Amari

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Me too...only I was sick infront of the whole class! new
      #121565 - 11/13/04 06:56 PM
Natalie1985

Reged: 08/09/04
Posts: 1329
Loc: UK - Leeds for uni, Merseyside for home!

OMG I really did think I was the only one out there like that...Im so glad you people are here...you make me feel more normal every single day! I always check for exits when Im out and obviously I know where every single toilet in town is...infact I was doing it 2day at the supermarket...eyeing up the nearest loo....lol! I also try to make sure that everytime I go home on the train I have a 20 pence piece with me because thats how much it costs to go into the toilets at the station and I feel so much better if I know I could actually get there if I needed too! I know exactly where my phobia comes from though...unfortunately I had to endure the embarrassment of being sick infront of the whole class at school! We were reading a book and Id had my turn to read out loud and suddenly came over all sick...next thing I knew the whole contents of my lunch (spaghetti hoops on toast) appeared all over the desk! The poor guy next to me nearly fell off his chair trying to avoid the sick! As if that wasn't bad enough the teacher then stood me at the front of the class and said....who would like to accompany natalie to the toilet?? To say I wanted to die at that moment was an understatement! Ive been paranoid ever since...would touch spaghetti hoops again...lol! Like Brittany Im funny over the salmonella thing aswell...I actually gave myself food poisoning from chicken last year(by accident of course) so I wont cook it in a pan anymore....god Im starting to feel nauseous typing this!lol!

--------------------
Natalie



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