Last week, I discussed some research that talked about the importance of telling your IBS story. In line with that, I offer you my newest Real Life Tips and Tales question:

• What Other Health Problems Are You Dealing With Alongside Your IBS?

As you may know, people with IBS seem to be at higher risk for other health problems. Here you can share your experience in regard to other health problems and find out how other people cope when they have more than one health problem at a time.

Sometimes your symptoms don't warrant another diagnosis, but they are vexing all the same. Read what other symptoms IBS patients deal with:

• What Other Symptoms Do You Have?

Here's hoping you all have a wonderful, IBS-quiet Thanksgiving Day! I am fortunate this year, no travel and no company. A perfect day, in my opinion. For those of you whose day might involve a little (or a lot!) more stress, take a moment to check out my Thanksgiving day survival tips:

• Thanksgiving Recipe for Digestive Health

Today marks the start of GERD awareness week. Did you know that IBS sufferers are at higher risk for the development of GERD and vice versa? So unfair! My newest article addresses this overlap between IBS and GERD:

• IBS and GERD: Why Do They Overlap?

In honor of GERD awareness week, the IFFGD sent out a press release discussing nocturnal reflux. This is a condition in which acid reflux and heartburn disrupts a person's sleep. For list of the symptoms of nocturnal reflux, see:

• Could GERD Be Keeping You Up at Night?

For comprehensive information on GERD, visit:

• Heartburn/GERD at About.com

Past research has shown that the quality of your relationship with your doctor can have a positive effect on your IBS symptoms. A recent study took a deeper look into what factors are involved in this positive effect. According to the study abstract, complex statistical analyses were conducted on data that was collected from 289 IBS patients. I did my best to try to sort throught the results to see if any of this information would be helpful to you. The one nugget that I gleaned was that subjects who did not receive a supportive relationship with their practitioner did have a better treatment outcome if they were given the opportunity to discuss their illness in the context of what the researchers called an "experiential interview".

Your takeaway? Speak up! Tell your story! Yes, I know the symptoms are embarrassing, but they are only descriptions of common body functions, not a reflection of you as a person. This study fits right in with the ongoing forum discussion regarding IBS awareness and advocacy. If you can't find anyone who will listen, feel free to post on my forum. As Dr. Frazier Crane says "I'm listening".

Related Reading:

• Is Your Doctor Right for You?

_Source:

_{Conboy, L.A., Macklin, E., Kelley, J., Kokkotou, E., Lembo, A., & Kaptchuk, T. "Which patients improve: Characteristics increasing sensitivity to a supportive patient-practitioner relationship." Social Science and Medicine November 2007 Articles in Press.}

As you all know all too well, the medication options for IBS are quite limited. Thus, it is always refreshing to hear that drug manufacturers are working to change this unfortunate state of affairs. Lexicon Pharmaceuticals has just announced some positive results of a Phase II clinical trial for a medication currently being called LX1031.

LX1031 is designed to treat "non-constipating" IBS. In this trial, patients were recruited who suffer from diarrhea-predominant IBS (IBS-D) or IBS alternating type (IBS-A). Results showed significant improvement in relief of IBS pain and discomfort, as well as stool consistency as compared to placebo. The medication was well-tolerated with no evidence of adverse side effects.

LX1031 is described as a "tryptophan hydroxylase (TPH) inhibitor". Luckily, the press release offers an explanation! TPH is involved with production of the neurotransmitter serotonin in the intestinal tract. LX1031 is thought to decrease the amount of serotonin in the digestive system thus providing symptom relief. (If this topic interests you, see: The Brain Gut Connection in IBS). One of the study measurements was to assess the amount of 5-HIAA in urine, which is a measure of the breakdown of serotonin. As was hoped, study results indicated a decrease in the amount of 5-HIAA in the urine of participants who received LX1031.

The fact that this medication is looking effective without nasty side effects is good news! What I am liking about this medication is that it works to alleviate pain, which many of you would describe as your worst IBS symptom. Because the medication did well in this study, the manufacturer will continue to test it for safety and effectiveness. I will keep you posted!

_Source:

_{Lexicon Announces Positive Phase 2 Results of LX1031 in Non-Constipating Irritable Bowel Syndrome Lexicon Pharmaceuticals Press Release. November 12, 2009.}

If you are like me, you might find that all of the information about the H1N1 swine flu is too much to try to take in. It seems like you can't open a newspaper, magazine or web page without some new facts being thrown at you. On the other hand, the H1N1 flu is not going away and so you can't completely turn a deaf ear to it all.

For you, my loyal readers, I have tried to find out what information you specifically need to know about the H1N1 flu, especially in terms as to how it relates to your IBS. The following articles boil it all down for you, short and sweet, your eyes really shouldn't glaze over:

• H1N1 Swine Flu Vaccine and IBS
• H1N1 Swine Flu and IBS

An encouraging discussion has recently been started on the IBS Discussion Forum regarding IBS advocacy. Stepjrn writes "In my opinion, silence and anonymity are our enemies in this case. IBS is a legitimate medical condition and the way we get more health care professionals and the general public to see that legitimacy and the importance of our needs is to come out of the closet and speak out loudly and en masse. We cannot expect others to fund or support our needs if we are not collectively willing to get behind our own cause and the organizations and other entities that are supposed to represent us."

Ed12 makes a good point as well: "If every IBS sufferer in the 3 countries I have already stated joined together and donated only one DOLLAR a month, just one DOLLAR a month, more than 100 millions dollars would be raised for funding of the disease each month, and that is only in three major countries around the world, not to mention other countries. Imagine how far we would go towards better relief in a year. In a year we would be able to raise more than 1.2 billion dollars. I'm sure that much hasn't ever been raised for any disease, but we can do that by only donating a dollar each, and it will be to get better relief in the future. I swear if this happens, there will definitely be a cure for IBS within 5 years."

These two readers bring up such a good point. The number of people who suffer from IBS is as Will Ferrell would say "ginourmous". Why doesn't IBS get the press and the funding that other health conditions get? Why do IBS patients stay locked in shame and silence? You might say that the symptoms are embarrassing, but as Stepjren so nicely points out in one of her posts, patients with Crohn's and colitis are not so silent, and they also deal with "bathroom issues".

Please think about what you can do to bring IBS into the forefront so that it gets the research dollars that are so desperately needed. The following articles might give you some ideas:

• IBS Advocacy
• Donating Opportunities for IBS

For other ideas, or if you have any ideas of your own as to how to increase IBS advocacy, please join in on the discussion on the IBS forum.

Linaclotide is a medication designed to treat chronic constipation, including IBS-C and CIC, that is currently undergoing testing as to its safety and effectiveness. The manufacturers of Linaclotide, Ironwood Pharmaceuticals, Inc. and Forest Laboratories, Inc. recently announced that the medication performed well in two Phase III clinical trials.

Statistical analysis of the results of both studies indicated that Linaclotide achieved the desired outcome of a "complete spontaneous bowel movement (CSBM)". This refers to a bowel movement that occurs without the use of a laxative, enema or suppository. Other effects of the medication included a decrease in bloating and abdominal discomfort, and an increase in the average number of CSBMs.

Linaclotide is a medication taken orally. It appears to work at the level of the gut and thus is not thought to act on the rest of the body, which usually translates to less side effects. It was designed to affect certain receptors within the lining of the intestine, resulting in an increase in fluid and faster transit time.

The companies are currently enrolling patients into two more Phase III trials with results expected late next year. It is certainly good to know that medications are tested thoroughly before they are available to the public, but given the lack to medication options for IBS, the whole process seems maddenly slow. My two cents.

Related Reading:

• Medicine for Constipation

_Source:

_{"Ironwood and Forest Announce Positive Linaclotide Results from Two Pivotal Phase 3 Trials in Patients with Chronic Constipation" Ironwood Pharmaceuticals Press Release. November 2, 2009.}

My first experience with biofeedback was when I took a training class at a convention many years ago. They asked for a volunteer from the audience, and being the good nerd that I can be (my husband calls me a Mousekeeter), I raised my hand. At the time, I was extremely pregnant, so I lumbered to the front of the room to get hooked up. For a person who can have a touch of social anxiety, I couldn't have possibly drew more attention to myself! Anyway, I told the instructor that I had a bit of a tension headache so he placed the monitor at various points around my head and face. The visual display on the monitor was so cool! As I watched I could see what I needed to do to release my muscle tension and, lo and behold, my pain eased.

Among the variety of health problems that biofeedback has been used for is severe constipation that results from a problem with the pelvic floor known as dyssynergic defecation. If you have severe problems with constipation or have been diagnosed with dyssynergic defecation, biofeedback may be an option for you. My new article provides an overview:

• Biofeedback for Constipation

Have you tried biofeedback? Please share your experience by leaving a comment below or on the IBS discussion forum.

Lactose intolerance may not be as prevalent as was once thought, suggests a study published in the September/October 2009 issue of the journal Nutrition Today. According to the study abstract, telephone interviews were conducted with over one thousand adults from the following ethnic groups: European American (EA), African American (AA), and Hispanic American (HA). The study found prevalence rates of 12 to 13 percent, much different from the approximately 25 percent figure normally stated.

Keeping in mind that this is only one study, it does suggest that you should not jump to a quick conclusion that you are lactose-intolerant. The downside of a misdiagnosis is that you might be avoiding certain nutritious foods needlessly. On the other hand, there is often an overlap between lactose intolerance and IBS. So confusing! The bottom line is that if you suspect you are lactose intolerant, have a discussion with your doctor. They may suggest diagnostic tests for the presence of lactose intolerance, the use of a food diary, and/or an elimination diet.

For more information:

• Lactose Intolerance
• IBS and Sugar Intolerance

_Source:

_{Niklas, T., et.al. "Prevalence of Self-reported Lactose Intolerance in a Multiethnic Sample of Adults" Nutrition Today 2009 44:222-227.}