Irritable Bowel Syndrome Message Boards | Re: Just back from Specialist

PaulineNZ

Its good your working with the doctor on all this.

Here is some Celiac Disease information.

http://www.aboutkidsgi.org/Celiac.html

"I said do you think this is ibs and he said he could not begin to give that diagnosis yet as it is a diagnosis of exclusion and he said he had not excluded every posibility."

This actually isn't so true anymore, but some doctors go by exclusion still to make sure.

You might print these two things also and take them with you next time they can really help.

Questions To Ask Your Doctor
Ten Questions To Ask Your
Doctor

http://www.medicinenet.com/script/main/art.asp?articlekey=13683

Current Approach to the Diagnosis of Irritable Bowel Syndrome
By: George F. Longstreth, M.D., Chief of Gastroenterology, Kaiser Permanente Medical Care Plan, San Diego, CA [Partcipate, IFFGD, 2001]

"In the past two decades, medical opinion has changed regarding how to diagnose IBS. The older view emphasized that IBS should be regarded primarily as a "diagnosis of exclusion;" that is, diagnosed only after diagnostic testing excludes many disorders that could possibly cause the symptoms. Because many medical disorders can produce the cardinal IBS features of abdominal discomfort or pain and disturbed bowel habit as well as other symptoms caused by IBS, this approach often led to extensive diagnostic testing in many patients. Since the era when such thinking about IBS was common, laboratory, motility, radiologic, and endoscopic tests have proliferated. Although each of these tests is useful in evaluating certain problems, their routine or indiscriminate use can cause unnecessary inconvenience and cost for patients, and complications even occur infrequently from some of the tests. Fortunately, physicians can now diagnose IBS in most patients by recognizing certain symptom details, performing a physical examination, and undertaking limited diagnostic testing. This simpler approach is grounded on recent knowledge of the typical symptoms of IBS, and it leads to a reliable diagnosis in most cases. Extensive testing is usually reserved for special situations. "

http://www.aboutibs.org/Publications/diagnosis.html

"Of course, the gastroenterologist in referral practice may not be content to accept these probabilities without first excluding those rare conditions overlooked by routine evaluations. So how far should the gastroenterologist go in the workup of patients referred to them who typically present with IBS, and have negative screening studies? One gastroenterologist, recently commented to me: "I order breath hydrogen studies and sprue serologies on all my patients referred with IBS". No doubt this comment reflects the concern that as referral gastroenterologists we have an obligation to contribute additional expertise to the diagnostic effort. "

http://www.romecriteria.org/reading1.html

"He is still taking the whole thing very seriously and was lovely to us,"

That is a major plus!!!

"Look the final diagnosis may be that it definitely is irritable bowel. "

This is possible and a person can also have IBS and another condition. She fits IBS in a lot of respects, but as mentioned some things do mimick SOME ibs symptoms.

That she is having a colonoscopy done is good and and endoscopy.

No matter what the cause of pain, what they said here is very important.

"defocus herself from the pain and think happy thoughts"

State of the art Pain research has come a very long way, distraction for chronic pain episodes can be very benefical as well as staying positive and learning methods to cope with chronic pain is VERY important and its a very serious matter. The brain remebers pain episodes and nerve pathways are developed from them and the continuial back and for communication between the brain and the digestive system.

There is a very complex relationship between the autonomic nervous system, which runs breathing, heart rate, digestion and other involuntary body functions and the sympathetic nervous system and parasympathetic nervous system and the enteric nervous system or "gut brain."

You might notice when she is in pain, her breathing becomes shallower and increase, muscles almost always tense up making pain worse, she might sweat, and perhaps turn a shade whiter. Reactions from the nervous systems.

This good on Abdominal Pain
Medical Author: Dennis Lee, M.D.
Medical Editor: Jay W.Marks, M.D.
What is abdominal pain?
What causes abdominal pain?
How is the cause of abdominal pain diagnosed?
Special problem in irritable bowel syndrome (IBS) of diagnosing the cause of abdominal pain
Why can diagnosis of the cause of abdominal pain be difficult?
How can I help my doctor to determine the cause of my abdominal pain?
Abdominal Pain At A Glance

http://www.medicinenet.com/abdominal_pain/article.htm

Answers to Common Questions about Bellyaches in Children

http://www.aboutkidsgi.org/Bellyaches.html

On the end of this is something to practice which can help.

Question from a 13-year-old in Oregon -- I have had stomach pains for over one year that make it hard for me to do anything. I have recurring abdominal pain syndrome. My doctor said there is nothing wrong with me and nothing he can do to treat me. Do you have any suggestions?
Answer -- We assume that you have been seen by a physician who gave you the diagnosis of "recurring abdominal pain syndrome," (functional recurrent abdominal pain).

Tests are done to look for the presence of disease as the cause of symptoms. If the tests find no evidence of disease, the symptoms are termed "functional." Diagnosis of this functional gastrointestinal disorder is based on the symptoms, after ruling out the presence of disease or tissue damage. These symptoms are defined as abdominal pain severe enough to disrupt routine activities three or more times during a three-month period. Studies show that it is pretty common, affecting 10%-15% of school-aged kids.

So if it is not a disease that is causing these symptoms (you are not sick and that is good news), what is causing it? The answer is not entirely clear. Ongoing research is looking for the explanation.

Recent studies point to an increased sensitivity of the sensory nerves in the intestines. Normal movements of your intestines may be perceived as cramps or other discomfort.

The intestines share nerve pathways with the brain. In many situations, when the brain reacts to something -- like the sound of a dentist's drill -- the intestines, or gut, pick up the same signals and react.

The majority of people will ultimately have some kind of gastrointestinal (GI) symptom when exposed to stressful situations. If your GI system is a bit too reactive, you will experience symptoms in more types of stressful situations than someone else will whose gut is not quite as reactive. What is stressful for one person may not be stressful to another, and lots of people don't even realize it when they get stressed -- they just feel sick.

Finally, there is the "gate theory" of how pain is experienced. When pain originates at some point, nerve messages pass through something like a gate on their way to the brain. The wider open the gate is, the more pain that is experienced. By thinking about and focusing on the pain site, we open the gate. Plus, feelings of anger or worry or sadness can open the gate.

However, we can also help close the gate. Turning attention away from the site or feeling of pain, through relaxation or focusing on some other activity, can help close the gate and lessen or even eliminate pain.

A well-known phenomenon that demonstrates this is that of the athlete who plays a game while injured, oblivious to the pain. The athlete is completely focused on the game and does not feel pain. Then, after the game is over, the athlete turns attention to the injury and feels pain.

Whatever the cause, you can do something about it! It takes some effort but there a number of ways that you can help yourself.

First, think about this example. Have you ever experienced a muscle cramp or a side-ache during strenuous running or exercise? You feel real pain in muscles that are not diseased. But they have been stressed beyond some point that in you causes discomfort. What do you do to avoid it in the future? You might think about what you were doing that resulted in the muscle pain. Maybe next time you do more warm-up exercises, or start out slower, or don't run as far.

The first time you felt a side-ache, you might have felt concerned and stopped running. After you learned that it was nothing to be concerned about, you may have barely taken notice the next time it happened, perhaps slowed down a bit, but then kept right on going.

This is the same type of thing that happens with functional recurrent abdominal pain. Your intestinal muscles may be causing you to feel pain. To get it under control, try this:

1) While the pain you feel is very real, do not worry that you are sick. You are not. Your body is reacting to events in a way that is causing you discomfort but is not cause for alarm.

2) Try to figure out if your symptoms are connected with anything else that may be triggering them. Do symptoms flare at certain times, before certain events, on weekdays, on weekends, etc? If you can identify triggering factors (like certain foods or activities) you can try to avoid them, or if that is not possible, try to deal with them in different ways.

3) Are you missing school because of this? Worry over missing school can make symptoms worse. Try to keep going.

4) Are you doing too much-school plus lots of outside activities? If so, take some time off to relax. Too much of anything can be stressful.

5) The next time you feel the pain, don't let it stop you. Keep on going. Practice focusing your thoughts on what it is you want to do next and then go ahead and do it. Don't let pain take your awareness hostage.

http://www.aboutkidsgi.org/questionsandanswers.html#fap

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My website on IBS is www.ibshealth.com

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