Irritable Bowel Syndrome Blog

I have seen a disturbing trend among my patients this summer. The majority of them seem to come into my office as quivering balls of stress! This is unusual, as in general the summer typically has a beneficial effect on mental health, as summertime on Long Island offers the benefits of such relaxing activities as boating and enjoying the beach. I have been puzzling over why people seem so stressed this year. I am thinking that it has got to do with the economy. The housing market has collapsed, homes are not selling or are in foreclosure, home equity lines of credit have dried up, gas is $4.50 a gallon and people are worrying about what their heating costs are going to be next winter. The effect of these outside pressures seems to be that people are walking around with a high level of muscle tension and anxiety.

As I spend my days in my office working with patients, I find that I am spending a lot of time reviewing relaxation exercises with them. It is very gratifying to me to see people visibly shed their high tension level within five or ten minutes. I always have people rate their tension level before and after doing the exercises and it is amazing to see that without any magic beans, their anxiety can be reduced from a 10 down to a 2!

An important part of the relaxation process is the use of visualization. In light of my theory regarding the effect of the economy on an individual’s tension level, it doesn’t surprise me that the most popular relaxation scene involves a lounge chair on a tropical island. What has been making me chuckle is that patient after patient describes a cool tropical drink sweating alongside of them! Obviously, people are feeling the need to escape from the pressures of modern life.

The beauty of relaxation techniques is that they allow you to escape whenever you need a break from the demands of your life. More importantly, they stimulate important physiological changes, changes that are essential for good physical health. And bodies that are afflicted with IBS especially need the benefits of relaxation. So, I am hereby reminding you of the need to be aware of, and respond to, the tension level of your body. Practice your relaxation skills and use them on a continual basis! Margaritaville is only a few deep breaths away!

• IBS and Relaxation: Turning Off the Alarm System
• How to Use Visualization for Relaxation
• How to Use Deep Breathing Exercises
• How to Use Progressive Muscle Relaxation

Thanks to pressure from my adolescent son, I have been trying desperately to purchase Nintendo'a new product, the Wii Fit, unfortunately to no avail. My thinking is that the Wii Fit would be great for someone with IBS. From what I understand, the game acts as your own personal trainer. How nice to be able to set goals and engage in a variety of exercises without having to leave the comfort of your own home, or more importantly, your own bathroom. Until I am able to get my hands on one (and I am trying, believe me!) and write my own review, you might find the following helpful:

• Review: Nintendo Wii Fit
• Can the Wii Fit Enhance Your Yoga Practice?

Summer may start in June, but for me the quintessential summer holiday is the Fourth of July. Like other holidays, July 4th poses unique challenges if you suffer from IBS. The typical fare is not very GI system-friendly and bathroom facilities at picnic areas are sometimes hard to find, or due to lack of cleanliness, hard to use. To help you to get the most enjoyment out of your July 4th holiday, I have put together a short guide, “How to Avoid Digestive Fireworks on the Fourth”. My wish for you is that your system stays nice and quiet so that you are able to relax and soak up the old-fashioned joys of America’s Independence Day.

My article “Diarrhea: Top Eight Things to Eat When You Are Feeling Awful” is consistently one of my most popular articles. To me, this illustrates the distress that diarrhea causes and reflects the desperate search for something that is going to make you feel better, or at the very least, not make you feel sicker. I put together a quick little poll to find out if the items on my list are what people are actually turning to. Take the poll to see how your choices compare to others. If you have any other suggestions for foods that are helpful during a diarrhea episode, please share them on the IBS discussion forum!

Just wanted to mention my sorrow over the passing of George Carlin. My kids just got introduced to George's unique brand of humor last weekend as we watched the very first episode of Saturday Night Live in which George was the first guest host. We can all give George credit for this nugget, “If four out of five people suffer from diarrhea, does that mean that one out of five enjoys it?” He will be missed.

My fellow guides here at About are always coming up with helpful advice. Two recent articles caught my eye as I thought they might be of use to my IBS readers. Trish Torrey, About.com Guide to Patient Empowerment, has just published “Medical Records, Privacy, Accuracy and Patients' Rights”. This article will teach you what your rights are regarding your medical records and how to protect yourself from errors and privacy violations.

Elizabeth Scott, About. Com Guide to Stress Management, has written a clever article called “How To Have A Truly Relaxing Staycation”. With the high cost of fuel, many people are staying close to home this summer and Elizabeth’s article gives you some pointers to make sure that your time off truly feels like a vacation. Given the difficulties inherent in traveling with IBS, a staycation might be just the thing you need to re-charge your batteries and enjoy the best of what summer has to offer.

No, not the rock band, although I am a big fan. Instead, I want to discuss a recent study that gives further support to the fact that IBS is not all in your head. Apparently, we have a particular type of nerve receptor that is responsible for the giving us the sensation of burning when we eat chili peppers. This new study looked at the relationship among the presence of IBS, the number of these receptors, and the experience of abdominal pain.

In order to measure the amount of the chili pepper nerve receptors, study participants underwent a colon biopsy procedure. The sample size was relatively small, with 23 IBS patients and 22 healthy comparison individuals. The results found that there were significantly higher amounts of fibers from the chili pepper nerve receptors in the IBS patients. There were also higher amounts of mast cells and lymphocytes, both of which are associated with inflammation. The number of chili pepper nerve fibers and mast cells were also associated with the amount of abdominal pain reported by the study participants.

This study offers some interesting evidence as to what is behind the visceral hypersensitivity noted in IBS. The long-term optimism is that perhaps medication can be developed that targets these specific nerve receptors. In the meantime, be careful when eating spicy food!

_Source:

Akbar, A., Yiangou, Y., Facer, P., Walters, J., Anand, P. & Ghosh, S. “Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain” Gut 2008 57:923-929.

Trying to navigate through all of the information available on the internet, or even just on this site, might seem quite overwhelming. In an effort to help you to streamline the process, I have put together two wellness guides for you. These comprehensive guides will help you to develop a multi-pronged strategy for dealing with what ails you. As new treatment options become available, I will add them into the guide, so bookmark the page that is relevant for you and check back regularly for updates!

• Chronic Constipation: Finding Your Path to Wellness
• Chronic Diarrhea: Finding Your Path to Wellness

Finally, some focus on prevention! A study in this month’s Lancet found that a vaccine can help to prevent travelers’ diarrhea. The vaccine, which targets that nasty bug E coli, was developed by the Iomai Corporation, and comes in the form of a skin patch. Study participants were given two patches, to be worn two to three weeks apart, before traveling to Mexico or Guatemala. The patches contained either a small amount of E coli or a placebo.

The results showed that the vaccine was safe. The individuals who received the vaccine had significantly less moderate-to-severe and severe diarrhea than the placebo individuals. The few vaccinated individuals who did get sick had significantly shorter diarrhea episodes than the placebo group.

This is excellent news in terms of prevention of IBS. It has been estimated that one out of every 10 individuals who experience an acute bacterial infection such as travelers’ diarrhea will develop a chronic case of IBS. If the incidence of travelers’ diarrhea can be reduced, the incidence of IBS will be reduced. Hooray! The vaccine is slated for further testing and it is hoped it will be made available in 2009.

For more information on travelers’ diarrhea:

• How To Avoid Traveler's Diarrhea
• Don't Ruin Your Vacation with Traveler's Diarrhea
• Symptom Checker: Travelers’ Diarrhea

Sources:

Frech, S. “Use of a patch containing heat-labile toxin from Escherichia coli against travellers' diarrhoea: a phase II, randomised, double-blind, placebo-controlled field trial” The Lancet 2008 371:2019-2025.

Garcia Rodriguez, L. & Ruigomez, A. “Increased risk of irritable bowel syndrome after bacterial gastroenteritis: cohort study.” BMJ 1999 318:565-566.

The title of this blog is a bit of a misnomer because I have not found any clinical research on the subject of IBS and cell phones. What I do want to discuss is my clinical experience as a psychologist on the subject of cell phones. My official statement on cell phones is that they are good if your car breaks down. Otherwise, they are not good for mental and physical health!

Our bodies were not designed to handle the immediacy of cell phones. When we were living in caves, our bodies developed the stress response to help us to survive running into a hungry lion. Luckily, the stress response worked, and the people to hungry lion ratio was favorable, and we have survived as a species. The problem with modern life is that by being available to other people on a 24/7 basis, which is what happens when your cell phone is tied to your hips, we are constantly running into the modern equivalent of hungry lions (e.g. demanding teenagers, unreasonable bosses) and our bodies respond to that. The stress response system was not designed for constant use and its constant stimulation can result in health problems.

So where does IBS fit in with all of this? If you suffer from IBS, then there is already a dysfunction in your body’s stress response system. This dysfunction is not necessarily caused by stress, but it exists all the same. So for your IBS health, and your overall health, you want to do whatever you can to reduce the strain on your stress response system. An easy way to do this is to turn off your cell phones!

The advantage of turning off your cell phone is that it provides you with the ability to respond to the wants of others at your own pace and at a time when you are able to calmly respond. I have heard too many stories about people walking in to the work place and getting a phone call from home from squabbling children. Patients in my own office lose valuable treatment time because they choose to answer their phones, which often turn out to be unimportant calls. When my patients object to my recommendation about turning off cell phones, I remind them that people survived for many years without having the immediate ability to communicate. You can too. If your kids are hurt, someone will find you quickly. You also always have the option of checking your messages frequently. The difference is that when you are checking your messages, you are focused only on that task and thus your body can respond appropriately. It is the constant interruption by cell calls that I believe to have a negative effect on health.

Well, that is my cell phone rant. If you would like to respond, please join the IBS discussion forum!