One of the nice things of being, ahem, of a certain age, is that the pressure to "do it up" on New Year's Eve becomes greatly reduced. The thing I worry most about is not that I have the perfect dress or matching shoes, but that I will be able to stay awake later than 10 PM! Dealing with IBS brings its own set of worries to holidays such as New Year's Eve. To help ensure that you have an enjoyable evening, please see my tips:

• "New Year's Eve with IBS: Your Stay or Play Guide to an Enjoyable New Year's Eve".

Have a wonderful evening!

Although I know your GI tracts have been very naughty, I am sure that all of you have tried to be "good for goodness sake". If I were able to be the IBS Santa Claus, I would give you all the gift of good health! Unfortunately, the power of positive thinking can only go so far. If you are celebrating the holiday, here are some last-minute tips for managing your IBS:

• Traveling with IBS
• Enjoying Parties with IBS
• What Not to Eat
• Dining Out with IBS
• IBS and Families

Have you seen that wacky story about a woman in Great Britain who was told she had IBS, but really had an enormous ovarian cyst? According BBC News, Janet Delaney's doctor gave her an initial diagnosis of IBS when she first complained of pain. When her pain continued, she made three separate trips to the emergency room before an ultrasound identified the cyst. At that point, the cyst had grown to 17 pounds. Luckily for Ms. Delaney, the cyst was non-cancerous.

This story triggers a variety of thoughts for me. On the one hand, it illustrates the problem with some physicians in that they are not attentive enough to what the patient thinks is the problem. The BBC article quotes Ms. Delaney, "I knew it wasn't just IBS. My mother suffers from that and I didn't have any of the symptoms." Yet her doctor, and those at the hospital, obviously did not pay proper attention.

On the other hand, to be fair, one must acknowledge that sometimes health problems have to develop before they are detectable. A patient that I saw recently had been complaining of twingy pain in her lower left abdomen. As she also suffers from chronic constipation, this seemed like classic IBS. A colonoscopy and an initial ultrasound showed nothing. It was only after several months, that a benign growth on the outside of the vaginal wall showed up on a CAT scan.

The problem here is how do you know when to accept an IBS diagnosis and when to pursue ongoing diagnostic tests? You may recall my discussion of a report that concluded that if you meet the Rome III criteria, there is a 98 percent chance that you have IBS and not something else. Those may be reassuring odds, but some people are going to fall into that other two percent. I guess the best you can do is to try to find a doctor you can trust and listen to your gut (pun intended).

_Sources:

_{"Huge cyst woman told she had IBS." BBC News December 15, 2009.}

_{Cash, B., Schoenfeld, P., & Chey, W. "The utility of diagnostic tests in irritable bowel syndrome patients: a systematic review" The American Journal of Gastroenterology 2002 97: 2812-2819.}

_{Spiegel, B. "Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality" IFFGD Digestive Health Matters 17:14-16.}

Stepjrn, our unsung IBS advocacy hero, has posted to my forum helpful information regarding how to let Senator McCain know your thoughts about his, shall I be kind and just say ignorant, comments regarding IBS on the Senate floor last week. Stepjrn credits Jeffrey Roberts of the IBS Self Help and Support Group for the contact information.:

• Contact Form: Senator John McCain
• Senator McCain's Health Legislative Assistant: Chris Bolan, 202-224-2235

As Stepjrn points out, your comments will be most effective if you live in Arizona. If you don't, contact anyone you know who lives there and email them the link! It is essential that people, such as the Senator, who have the power to direct money toward IBS research, are educated as to the seriousness of IBS. Don't be shy - tell your story! Advocacy leads to education, which leads to funding, which is our only hope for more effective treatments.