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.}

In my mind, the real IBS experts are all of you! You are the ones who deal with the pain, the disruption, the worries about food, and the bathroom issues on a daily basis. I have such a strong belief in the power of your experiences that your words were the basis of my second book. Here at About.com, I am so happy that we have the opportunity to let you share your experience with other readers as well through our recently added "Share Your Tips" articles. Over the past several months, I have been adding new "Share Your Tips" articles, and many of you have generously shared your time, your stories, and your solutions. Because these articles are so helpful, I have pulled them all together into one place so that you can easily find them. Look at the Topic list on the left side of my home page:

• Real Life Tips & Tales

Spend a few moments browsing through these articles - who knows what you might learn! And, if a subject strikes you, share your thoughts. Again, who knows what positive effect you might have on another person who is walking in your same IBS shoes.

Considering the high prevalence of diarrhea-predominant IBS, it seems like an absolute crime that conventional medicine has so little to offer in the way of treatment. The only medication that currently has FDA approval for the treatment of IBS-D is Lotronex. Unfortunately, like many things IBS, the Lotronex path has been a bumpy one. My newest article takes a comprehensive look at Lotronex:

• Lotronex for IBS-D

As you may recall, last week I told you that the manufacturers of Lotronex are offering financial assistance for Lotronex users:

• Co-Pay Assistance for Lotronex

Coming from a large Irish-American family, I would be an expert on family dysfunction even without my doctoral degree. I know first-hand how outside stressors can disrupt family harmony. From my training, I know that studies have been done which not only look at the effect that an illness can have on family life, but how family life can affect the severity of an illness.

I have had the great fortune to be in touch with two individuals who have devoted their careers toward understanding and treating the functional gastrointestinal disorders, particularly IBS. Drs. Mary-Joan and Charles Gerson are a husband and wife gastroenterologist/psychologist team who practice in New York City. They graciously agreed to share their experience in the area of IBS and family relationships with me so that I could share it with you. In the following interview, you will see that in addition to explaining their research findings, they offer practical suggestions to help you and your family cope with your IBS in the healthiest way possible:

• IBS and Family Relationships

To learn more about the work of the two Drs. Gerson:

• The Mind-Body Digestive Center

Do you think your family helps or hurts your IBS? Share your experience and find out how family life is for other IBS sufferers:

• Does Your Family Help or Hurt Your IBS?

May all the ghosts and goblins be lurking outside your door and not inside your intestinal tract! Here is hoping you are feeling well enough to enjoy this goofy holiday. In order to make sure you have the best day possible, I offer you some helpful tips:

• Going to Parties with IBS
• Dining Out with IBS
• Think Calm, Not Empty
• Halloween Candy and Food Allergies

Save the date! The newest "Evening With the Experts" free online chat offered by the UNC Center for Functional GI & Motility Disorders has been scheduled for Tuesday, November 4th, 2009 from 8:00 to 10:00 PM EST. This month's topic is "A Discussion on WebMD Videos and Articles" with none other than the great Douglas A. Drossman, M.D. Dr. Drossman is one of the world's top experts on IBS. To access the discussion, click on this link ten minutes prior to the scheduled time.

The UNC Center has set up an archive page, where you can watch the video or listen to the audio portions of all of the chats that have happened to date. I have only heard good things about these presentations, so be sure to check them out!

• UNC Evening With the Experts
• Evening With the Experts Archive Page

Believe it or not, your thoughts about what caused your IBS may affect how you feel. A new study published in the November 2009 issue of the Journal of Psychosomatic Research casts some interesting light on the subject.

According to the study abstract, eighty-eight individuals with IBS agreed to complete a variety of questionnaires having to do with their symptoms and their theories regarding their illness. The patients beliefs about what caused their IBS fell into three main categories: physical illness, "intrapsychic factors" (psychological causes), and stress.

Interestingly, the researchers did find a relationship between causal beliefs and severity of symptoms. The patients who attributed their IBS to primarily physical causes reported more IBS symptoms and had a lowered physical quality of life than those who had different beliefs. The patients who attributed their IBS to intrapsychic factors had "reduced mental quality of life", which is bad, but "enhanced physical quality of life", which is good.

I always have a problem with this type of research. A relationship was identified, but one cannot say that the beliefs caused the increase in suffering. It is possible that those whose symptoms are worse might be right in their assessment that their symptoms are due to physical factors, while psychological factors might play a larger role in milder forms of the disorder. The bottom line is that as of right now, no one knows what causes IBS. Your take-away from this might be to keep an open mind regarding what causes your illness - physical, psychological and psychosocial stress - and use this open-mindedness to develop a comprehensive management approach.

Related Reading:

• Five Reasons Why IBS Is Not All in Your Head

_Source:

_{Riedl, A., et.al. "Subjective theories of illness and clinical and psychological outcomes in patients with irritable bowel syndrome" Journal of Psychosomatic Research 2009 449-455.}

Okay, okay, I admit I am a little late in coming to the party. Apparently Promethus Laboratories, Inc. put out a press release (Reuters) on September 9th of this year announcing a co-pay assistance program for patients who are taking Lotronex (alosetron). This financial assistance program is available to any patients who meet the strict prescription guidelines for Lotronex.

Lotronex is the only FDA approved medication for the treatment of diarrhea-predominant IBS (IBS-D). Due to concerns about serious side effects, Lotronex is only available to women who have chronic, severe IBS-D symptoms who have not responded to other forms of treatment and who have no history of constipation.

Under the new savings program, patients are only responsible for the first $50 of their copay. Following this, patients are eligible to receive savings up to $250. This program is in addition to Prometheus' policy of providing a voucher for a two-week sample to new patients.

In these days of financial hardship, I am sure that any help is appreciated. It just blows the mind that the savings plan reduces the co-pay to $50. I shudder to think what the total co-pay is! Unfortunately, illness often comes with a high financial price, in addition to the toll it takes on quality of life. As I am not a political person, I will leave it at that and let the health care reform individuals take the conversation from here!

Related Reading:

• Medication for Diarrhea

When I was in graduate school, one of my professors, Dr. Raymond DiGuiseppe, was famous for saying "Diaphragmatic breathing cuts anxiety by 50%, so teach it!" Now, I am telling you, relaxation exercises really work, so use them! My latest article compares and contrasts the most popular forms of relaxation techniques, so that you can choose which of them, or which combination, works best for you.

• Three Easy Relaxation Exercises

Eva posted the following on the IBS Discussion Forum: "Was wanting to know if anyone regularly gets the flu shot, and if you plan to get the H1N1 shot if/when it becomes available to you. I've never had a flu shot -- but work w/ elementary kids this year so I probably will be HIGHLY encouraged to get both shots -- Just wondered if anyone had any adverse effects with IBS symptoms?" If you have any thoughts on the subject, please feel free to post a response.

For more information on the H1N1 Vaccine:

• Is the H1N1 Swine Flu Vaccine Safe?, by Kristina Duda, R.N., About.com Guide to Cold/Flu.