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Research unveiled at the American College of Gastroenterology's (ACG) 77th Annual Scientific meeting in Las Vegas suggests a possible overlap of symptoms of two prevalent GI disorders: irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) and further suggests a possible link between subtle GI tract inflammation and IBS symptoms -- a link that is also the focus of the first systemic review of the literature on this topic and an editorial both published in this month's American Journal of Gastroenterology. One study presented October 22 found that mesalamine granules, an anti-inflammatory drug used to treat ulcerative colitis, improved abdominal pain and stool consistency in diarrhea-predominant IBS. In the second study, researchers found that tricyclic antidepressants (TCAs) -- which are commonly used to treat IBS patients -- may be effective in managing moderately-severe functional symptoms such as abdominal pain and diarrhea in patients with inflammatory bowel disease.
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IBS-type symptoms may pose a challenge for the physician caring for the patient with IBD, especially, when they occur in the context of apparent remission of IBD. In this situation, IBS-type symptoms may represent ongoing but clinically unapparent inflammation. New diagnostic methods such as measuring fecal calprotectin levels may prove helpful in addressing these clinical dilemmas," says Eamonn M.M. Quigley, M.D., FACG, Professor of Medicine and Human Physiology and a Principal Investigator at the Alimentary Pharmabiotic Centre at the National University of Ireland, Cork, Ireland.
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
Very interesting and disheartening at the same time. Why can't they give this "phenomenon" a name? It's MC!! Give us some credit where credit is due!!!! I wonder if anyone here has had fecal calpeotectin levels checked. Would the levels be a good indicator of MC severity?
I have long thought that I have an "IBS component" to my MC. By that I mean that I know I am super sensitive to stress and that my emotions seem to go directly and immediately to my gut. I can feel it happening. This is another missing puzzle piece for some of us. And it fits beautifully with the recent discoveries by Carol and Amber that they improved once they began taking amitriptyline (Elavil), which, of course, is a tricyclic antidepressant (TCA). Good find!
Love,
Polly
Blessed are they who can laugh at themselves, for they shall never cease to be amused.
I'm the same way....super sensitive gut! Amitriptyline has definitely helped me over the years (20 years) but no longer works or maybe it is working and that's why I only have 1 to 3 episodes of WD (without meds) a day rather than 10 plus. That drug has been a lifesaver for me. Though trying to get off of it is a nightmare.
Terri
Diagnosed with Lymphocytic Colitis in July, 2012 then with Celiac in November, 2012.
Polly
the release of the article this week was very intersting as only last week did I have this discussion with my new GP. (insert the twillight zone theme music.........)
the BP meds i have been trying have caused me to have 'MC Mud' for the past few weeks (including accidents) when i mentioned this, she did the whole range of inflammation/autoimmune tests to see what was going on. There was no inflammation, no ANA, nada.
given my history of D & C, she said it is possible to have MC in remission and have IBS.
to be fair, as we well know, the only way to confirm if MC is active or not is; a colonscopy with a reliable GI who knows what he is doing, and after the posts this week, a reliable pathologist. The GP only has things like blood tests and poop tests to guide them.
I think i said something similar 14 months ago when the new GI specialists said 'IBS'; it doesnt matter what you call it, any digestion symptoms occuring is an indicator of irritation and inflammation of the bowel.
IBS is like MC, people are different, different triggers, different major symptoms, a treatment that works for one may not work for another.
the key is to find the trigger, eliminate or manage it, and do what you can to be well.
and given this was published in the gastroenterlogy journal - this is what most GI's will be reading this month.....................
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
given my history of D & C, she said it is possible to have MC in remission and have IBS.
to be fair, as we well know, the only way to confirm if MC is active or not is; a colonscopy with a reliable GI who knows what he is doing, and after the posts this week, a reliable pathologist. The GP only has things like blood tests and poop tests to guide them.
I think i said something similar 14 months ago when the new GI specialists said 'IBS'; it doesnt matter what you call it, any digestion symptoms occuring is an indicator of irritation and inflammation of the bowel.
IBS is like MC, people are different, different triggers, different major symptoms, a treatment that works for one may not work for another.
the key is to find the trigger, eliminate or manage it, and do what you can to be well.
and given this was published in the gastroenterlogy journal - this is what most GI's will be reading this month.....................
So why doesn't it occur to the medical luminaries that what might possibly be wrong is the categories they use to classify intestinal disorders. Diseases aren't facts. They are ideas constructed by doctors/researchers in order to understand symptoms. Historically the way diseases are classified have changed over time as knowledge and understanding have changed. In other words it is not unlikely that the ibs/mc distinction has no factual basis and needs to be changed rather than giving people multiple diagnoses for what are identical or related symptoms.
IMO, you are right on target. The primary problem appears to be that doctors have no way to define any stage of any disease that does not fully comply with at least the minimum diagnostic criteria for that disease. But clearly, virtually any disease has various stages before it reaches full diagnostic maturity, and again after the symptoms have been suppressed sufficiently by treatment, so that it no longer meets the diagnostic criteria, but symptoms are still present.
With LC, for example, that stage occurs when the lymphocyte count is between what is considered to be a normal lymphocyte count, (around 5 lymphocytes per 100 enterocytes), and 20 lymphocytes per 100 enterocytes, (which is the minimum count considered to be diagnostic for MC). So what happens with all the people who have lymphocyte counts between 5 and 20? They have IBS, obviously, because they fail to meet the diagnostic criteria for LC.
IMO, that's plain stupid. How else can you define it. Every one of us goes through that stage on the way up, and again on the way down. And if we seek a professional opinion when our count is in that zone, we will almost surely be told that we have IBS.
The medical profession needs to get it's ducks in a row and figure out how to diagnose these diseases when they are in the early (and late) stages. That goes double for celiac disease and gluten sensitivity in general. Millions of people suffer because of the crude diagnostic techniques that are still in use. In this day and age, we should be able to do much better.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
this myself. I met with my new PCP today, she looks about 12 years old to me, but I love her enthusiasm and we talked for an hour going over my blood test results, which were all perfect, which makes me wonder why I'm still miserable, but we also talked about drugs and drug companies and my experience with my provider (which is a clinic that's connected to her med school) and my previous experience there and what I've been mis/dx with by the "specialists" there and what I've done to avoid steroids over the years while I was figuring out what was wrong w/me. I was pleased that she said that when she was in Med School, the drug reps were forbidden to contact the students. I think we may be seeing a way too slow change occurring for what we'd like, but my daughter got a full ride to nursing school after writing a scathing essay on her experience w/western med. on her scholarship application and I think that says something and my new Dr. thought it did too.
The medical profession needs to get it's ducks in a row and figure out how to diagnose these diseases when they are in the early (and late) stages. That goes double for celiac disease and gluten sensitivity in general. Millions of people suffer because of the crude diagnostic techniques that are still in use. In this day and age, we should be able to do much better.
In the end we talked mostly about antidepressants, as I am depressed, and not interested in taking drugs for this, so she's going to see if the resident MSW can refer me to someone with experience in CBT, something I attempted with my last therapist who just wanted to chat. Seriously, I'm anxious to see what she comes up with, but I have no expectations. I'm in perfect health blood-wise, my TSH and cholesterol and BP couldn't be better. I guess I need to re-wire my brain, I wonder how big a part trauma/PTSD plays in this.
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
Connie wrote:I wonder how big a part trauma/PTSD plays in this.
A huge part, IMO.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Connie
the medical profession are in the mode of mask the symptoms, we dont have the time or resources to get to the cause and treat the core of the situation.
and sadly, any half decent wholistic practioners who do get to the core, are in demand and charge a fortune. Being well should not be this much hard work and expensive. *sigh*
koala bear hugs from aus
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
She wrote down your name and is going to order it.
I've been really fortunate to have my ND, Gabes, I saw him last week and he gave me some Lavela, which is a lavender oil that has had some success as a mood elevator. He isn't cheap, but he's not out of line and the surgeries he's saved me from having would have had co-pays that would have probably been close to 2 full years of prolotherapy. But you're right for what it costs, you'd think there would be more professionals who care enough to try to get to the core.
Hugs back.
Connie
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
I believe this is a big part of what we deal with. I hope you find a good therapist who uses CBT. When I was a therapist (years ago) I used it and loved it. People are quick to learn it and once they get in the habit of applying it, they are much happier. Empowered really-- and to me that's the point of therapy. You should leave empowered with new skills.
There are some good books and workbooks out there too. I recently bought Mind Over Mood for my daughter, who occasionally gets tripped up by something in college. These are good skills to have.
Good luck,
Carol
“.... people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou
Appreciate your feedback. I've learned ways to stop PTSD from escalating by using techniques I read about and have been very successful with that. I'm glad to hear that you have a respect for CBT, just wish I hadn't wasted the 13 sessions w/my last therapist. Starting from the beginning w/a new one is going to be expensive and shouldn't have been necessary if my previous one had known her stuff. I know what my issues are, have done a great deal of work to understand the why's and how's and have no interest in discussing the grizzlies with a therapist, just want to start where I am now and move forward. I'll look into Mind Over Mood, don't think I've read that one.
Connie
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
Connie, when looking at materials look under Rational Emotive Therapy as well as Cognitive Behavioral Therapy. RET was the fore runner, but the premise is the same-- realize your self talk, confront that, change your thinking and change how you feel.
You will be a therapist's dream. Be picky and get one who's on the same page. Generally with CBT people don't need a lot of sessions. Once you have the strategy and can apply it, you are empowered.
Carol
“.... people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou
Visit the Microscopic Colitis Foundation Website
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Your new PCP sounds promising.
