Get to the “Gut” of a Vicious Cycle: Irritable Bowel and Anxiety

Posted by Georgeann Fries | Last updated: Mar 25, 2013 Fragile Emotion The Link between Anxiety and IBS Does anxiety beget IBS? Does IBS beget anxiety? This is a classic, “What comes first, the chicken or the egg” dilemma. Can the mystery be solved? Anxiety is often linked with Irritable Bowel Syndrome. Anxiety, in fact, can create, contribute to and exacerbate the symptoms of IBS. Concurrently, the symptoms of IBS have a strong impact on mood and can create stress and feelings of anxiety. As the cycle continues, both patient and physician must dissect this vicious cycle in order to make a valid diagnosis. Most probably anxiety and IBS fuel each other. Anxiety Anxiety can be defined as a psychological and physiological reaction to a stressor which expresses itself in fear, worry, uneasiness and/or dread. Medical researchers at The Anxiety Disorders Association of America (ADAA) have learned that there exist somatic, emotional cognitive, and behavioral components to the root cause of anxiety. It is important to note that anxiety, itself, is a normal reaction to a given stressor. It is when anxiety becomes excessive, that physicians classify this reaction as an anxiety disorder . IBS (Irritable Bowel Syndrome) In her book, The First Year: IBS , Irritable Bowel Syndrome is considered to be a functional disorder of the lower intestine characterized by chronic abdominal pain, bloating, abnormal extension, and abnormal bowel movements which alter bowel habits. IBS is a disorder of elimination. Once no known disease is found, patients are diagnosed with IBS because symptoms have no detectable organic cause.

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Eating for IBS Celebrates 10 Years on the Best Seller List

Today, her ground-breaking book Eating for IBS celebrates more than 10 years as a best seller on special diet lists and over 250,000 copies sold worldwide. Save Seattle, WA — ( SBWIRE ) — 01/01/2013 — If youre new to the dietary management of Irritable Bowel Syndrome, learning what you can and cant eat without triggering painful symptoms used to be an even more painful process. Then the book Eating for IBS confirmed what every IBS sufferer instinctively knew: diet plays a direct role in gut function, and the abdominal pain, diarrhea, constipation, and bloating from Irritable Bowel Syndrome can be directly controlled through diet. The Eating for IBS diet makes the difference between living a normal, happy, outgoing life versus spending every day stuck in the bathroom enduring pain, bowel dysfunction, and misery. Contrary to what many IBS patients and even doctors still believe, eating for IBS does not mean deprivation, never going to restaurants, boring food, or a limited and therefore unhealthy diet. It does mean learning to eat safely by realizing how different foods physically affect the GI tract, and how foods can help or hurt both diarrhea AND constipation, as well as abdominal pain, bloating, gas, and nausea. Foods can either prevent or trigger IBS symptoms. For example: – There are two kinds of fiber…one soothes the colon and regulates gut function but the other can cause severe IBS attacks – Dairy is a common trigger…even in people who are not lactose intolerant – Peppermint and fennel can prevent pain, spasms, and bloating better than some drugs – Bland foods are not automatically safe foods – How you eat for IBS is just as important as what you eat for IBS With Eating for IBS, Heather Van Vorous, who has suffered from IBS since childhood and gradually learned to control her symptoms through dietary modifications, offered sympathetic information tailored specifically to the needs of IBS sufferers. She provided a comprehensive overview of IBS, explicit eating and cooking strategies, travel and restaurant advice, daily menus, supermarket ideas, and 175 delicious IBS-friendly recipes. How delicious could those recipes be? Eating for IBS was a finalist for the IACP (International Association of Culinary Professionals) Health and Special Diet Award – also known as the “Julia Child” award, and it led to the Seattle television show Heather Cooks! IBS sufferers have been thrilled to discover they can enjoy traditional homestyle cooking, ethnic foods, rich desserts, snacks, and party foods – and don’t have to cook unusual or special meals for themselves while their families follow a “normal” diet. Eating for IBS forever revolutionized the way people with Irritable Bowel Syndrome eat – and live. Irritable Bowel Syndrome affects up to 20% of the population and symptoms such as diarrhea, constipation, abdominal pain, bloating and gas can either be triggered or prevented through diet.

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Irritable Bowel Syndrome Workup

Dr. Jacqueline Gerhart: Irritable bowel syndrome

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Jacqueline Gerhart is a family physician practicing at UW Health’s DeForest-Windsor Clinic. Send questions for her to or Wisconsin State Journal, Attn: Health Column, P.O. Box 8058, Madison, WI 53708. We cannot reply to all letters. Dear Dr. Gerhart: I was told by my doctor that I have IBS, but when I check online for information about IBS, I see it can mean either irritable bowel syndrome or inflammatory bowel syndrome. Are they the same thing? Dear Reader: Unfortunately in the medical field, we often use acronyms without clearly describing them. Usually, when a general medical doctor uses the term IBS, he is referring to irritable bowel syndrome. This is not the same as inflammatory bowel syndrome, which is more correctly termed inflammatory bowel disease, or IBD. Both can cause diarrhea, cramping, bloating, abdominal pain, decreased appetite, nausea and bowel irregularity. Both can have symptoms that come and go, and both can run in families. But lets talk about the differences. Irritable bowel syndrome, or IBS, is very common, occurring in 10 to 15 percent of the population, and is twice more common in women. Sometimes called spastic gut, IBS is characterized by changes in bowel movements.

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Irritable Bowel Syndrome

Some doctors may suggest using an over-the-counter fiber supplement. Use of fiber is most important for patients with predominantly constipation as their main complaint. Fiber may not be as useful for patients with predominantly bloating or diarrhea. Avoiding alcohol and caffeine are also important in controlling diarrhea in IBS. Recommended lifestyle changes consist of regular exercise, alleviating stress, getting a good night’s sleep, reserving enough time to have a bowel movement and having a bowel movement when needed. For moderate to severe IBS, the doctor may recommend a pharmaceutical approach to ease the symptoms of IBS. Cramping and pain may be relieved by an antispasmodic medicine such as hyoscyamine (Anaspaz, Cystospaz, Levsin) or dicyclomine (Bemote, Bentyl, Di-Spaz). For diarrhea, the doctor may recommend loperamide (Imodium) or cholestyramine (Questran) and for constipation, osmotic laxatives such as lactulose (Chronulac, Kristalose) or sorbitol are helpful. A newer medication approved only for constipation-predominant IBS is tegaserod (Zelnorm). Its action involves stimulating the colon to contract to promote regular bowel movements and reduce bloating. For patients suffering from frequent and severe pain that impairs their daily functioning, a physician may prescribe an antidepressant such as amitriptyline or nortriptyline. These drugs work by increasing the release of neurotransmitters in the brain, thereby preventing the transmission of pain and reducing pain perception. Although doctors note that IBS is a disorder of colon motility and sensation, psychological and behavioral treatments represent important supplemental therapy for patients with IBS, regardless of the severity of the condition.

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Irritable bowel syndrome: Profile of an invisible illness

Why Peppermint Eases Irritable Bowel Syndrome

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The result was that symptoms among the treated patients improved dramatically. After receiving counseling for the emotional upsets, 89 percent of the patients reported less pain as a result; 96 percent had less diarrhea, 8 percent had less vomiting. Researchers who conducted the study concluded that “the symptoms of irritable bowel syndrome were seen as a physical expression of emotions caused by recent loss or ongoing stressful life situations.” (Mind/body health: The effects of attitudes, emotions and relationships) Irritable bowel syndrome is defined as a “painful combination of cramping, diarrhea, and occasional vomiting.” Johns Hopkins Medical School Associate Professor of Behavioral Biology William E. Whitehead has been quoted as stating that the “gastrointestinal tract is particularly susceptible to emotional stress and very readily comes under the influence of external factors and events.” (Mind/body health: The effects of attitudes, emotions and relationships) How does stress and emotion contribute to irritable bowel syndrome ( IBS )? Coordination of the gastrointestinal tract shuts down under stress. “Eating while under stress can result in stomach bloating, nausea, abdominal discomfort or cramping, and even diarrhea.” (Mind/body health: The effects of attitudes, emotions and relationships) What does this mean for Ontarian’s with irritable bowel syndrome (IBS)? For one it means that patients with IBS who receive adequate treatment for their underlying conditions during the early stages (depression and insomnia being common and also invisible illnesses associated with IBS) should see a reduction in their IBS symptoms. Where can Ontarian’s with irritable bowel syndrome (IBS) go for help? This will depend somewhat on how long the symptoms have been present. As mentioned earlier, treatment of underlying syndromes such as depression and insomnia during the early stages of IBS may alleviate the symptoms of IBS. If you have had IBS symptoms for an extended period a gastroenterologist referral from your primary healthcare provider may be required in order to determine the amount of damage (if any) has been done to your digestive tract. Where can Ontarian’s find additional information on irritable bowel syndrome? There are a number of books and online resources available to Ontarian’s with IBS. Speak with your primary healthcare provider to find out if you have IBS or another gastrointestinal disorder. You may also find additional information on the Canadian Society of Intestinal Research website including this 30 second IBS test.

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Angelina Jolie Surgeon

Enter your email address * Why Peppermint Eases Irritable Bowel Syndrome By Deborah Ross HERWriter May 4, 2011 – 10:48am 1 comments View Comments Photo: Getty Images How about a nice cup of peppermint tea? Do you remember your mother or grandmother offering that simple remedy whenever you complained of a mild stomachache? Over the generations, more and more Americans have caught on to peppermint as a provider of relief. Even those with more serious stomach conditions, such as irritable bowel syndrome, have turned to peppermint. And recently, scientists have figured out exactly why peppermint works. A study out of Australia that will soon be reported in the journal Pain explained that peppermint activates an anti-pain channel in the colon. Even in cases of inflammation in the gastrointestinal tract, peppermint contributes to pain relief, according to Dr. Stuart Brierley from the University of Adelaide. This Article Vote Saved My Life In a University news release Brierley added, Our research shows that peppermint acts through a specific anti-pain channel called TRPM8 to reduce pain-sensing fibers, particularly those activated by mustard and chili.” Among the triggers for irritable bowel syndrome are fatty and spicy foods, coffee and alcohol, but Brierley said the connection between what we consume and the onset of pain is complex. He said he is encouraged by the possibility of using peppermint to find a mainstream clinical treatment for IBS, given that it can be such a debilitating condition. The Australian study also looked at whether an IBS patient who at some point has had gastroenteritis can have nerve pain fibers that are heightened, or more susceptible to discomfort. On his website, Dr.


Emu Oil As An Alternative Treatment For Irritable Bowel Disease, Study

In addition, these carbohydrates are fermented by intestinal bacteria, causing gas. In a 2010 study in Alimentary Pharmacology Therapeutics, researchers evaluated stool output in a small group of individuals who required an ileostomy bag, finding that water content in their ileostomy bag increased by 20 percent on a high FODMAP diet compared to a low FODMAP diet. Scientists also demonstrated that intestinal gas levels increase in both healthy individuals and those with IBS following a high FODMAP diet, with higher levels among those with IBS (Journal of Gastroenterology Hepatology, 2010.) Who can’t handle FODMAPs? Everyone, whether they have IBS or not, may have some problems absorbing FODMAPs. Humans lack the enzymes to break fructans and GOS into digestible sugars. And lactose is malabsorbed in people who are lactose-intolerant and lack the intestinal enzyme lactase. Fructose is malabsorbed in 30 percent to 40 percent of individuals, likely because of its slow absorption in the intestine. Fructose is best absorbed when glucose is also present in a similar amount in the food, such as is found in fruits like bananas, cantaloupe and grapes. Polyols are large sugar molecules that are poorly digested by most people. Not all individuals will malabsorb all FODMAPs. If you have IBS, it’s a good idea to see a health care professional, who can determine (through a breath test) whether you malabsorb fructose or lactose. People with adequate absorption of these carbohydrates will not need to restrict them. Individuals with IBS seem to be more vulnerable to the aftermath of poorly digested FODMAPs, perhaps because of the greater amount of gas produced in their intestine, or because the disordered movement of their intestine traps gas and fluid. How to start a FODMAP diet?

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Irritable bowel syndrome

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Limiting certain carbs may help ease irritable bowel syndrome

Tweet AsianScientist (Apr. 22, 2013) Emu oil may be useful for the treatment of common bowel diseases in addition to the intestinal damage caused by cancer chemotherapy, according to a new study. Used by Australian indigenous populations as a skin wound treatment, and anecdotally regarded as useful in reducing bowel inflammation, research at the University of Adelaide has not only supported emu oils anti-inflammatory properties, but shown that it can also help to repair damage to the bowel. Laboratory experiments by Physiology Ph.D. candidate Suzanne Mashtoub Abimosleh have shown that emu oil accelerates the repair process, following disease-causing injury, by stimulating growth of the intestinal crypts. The crypts are the part of the intestine that produces the villi which absorb the food, and longer crypts and villi allow for better absorption of food. Disorders of the gastrointestinal tract, such as the inflammatory bowel diseases and chemotherapy-induced mucositis, are associated with malabsorption of food together with inflammation and ulceration of the bowel lining (mucosa), said Abimosleh. The variable responsiveness of treatments to these diseases shows the need to broaden approaches, to reduce inflammation, prevent damage and promote healing. In the study, emu oil treatment produced greater elongation of intestinal crypts, indicating enhanced recovery and repair, and reduced the severity of damage in intestines affected with ulcerative colitis. The treatment was also shown to significantly decrease acute intestinal inflammatory activity in non-steroidal anti-inflammatory drug (NSAID)-induced gastrointestinal disease and in chemotherapy-damaged intestines. The symptoms of mucositis which include painful ulcers throughout the gastrointestinal tract are experienced by 40-60 percent of all cancer patients undergoing chemotherapy worldwide and currently there are no effective treatment options, said Abimosleh. The researchers hope to take the treatment into clinical trials, possibly initially with patients suffering from conditions such as irritable bowel syndrome. Source: University of Adelaide ; Photo: The b@t/Flickr/CC. Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff. More from Asian Scientist Magazine

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Turning down the gas

Low-FODMAP recipes.

Cauliflower, onions, garlic, apricots, chickpeas and yoghurt are just a few of the otherwise healthy foods that can cause problems for some sensitive people. These foods all contain types of carbs that we don’t digest and when they arrive in the large bowel undigested they ferment and create gas. “When there’s a lot of gas it puts pressure on the gut and the nerve endings of the bowel and this can make the brain overreact and register pain.” For most of us this is a non-event, but for the 15 per cent of people with IBS this gas can trigger bloating, discomfort and pain pain that’s occasionally bad enough to send people dashing to Accident and Emergency, says dietitian Dr Sue Shepherd of La Trobe University’s Department of Dietetics and Human Nutrition who first identified these carbs as culprits in IBS. Low-FODMAP recipes. These fermentable carbohydrates can also change how quickly the bowel works – in susceptible people they can lead to constipation and diarrhoea or a combination of both,” she says. The trick to taming these symptoms is having fewer fermentable carbohydrates in the diet research at both Monash University and London’s Kings College Hospital has found that this works for around 75 per cent of people with IBS. While a low FODMAP diet puts some healthy fibre-rich foods off limits, it doesn’t mean sacrificing fibre, says Shepherd, the author of Low FODMAP Recipes, a new cookbook to help people with IBS make meals that minimise the gassy effects of FODMAPS. Although wheat, rye, barley and many vegetables including peas and mushrooms can cause problems, there’s still brown rice, quinoa, oats and buckwheat, as well as plenty of other vegetables. Spelt, a form of wheat, is also a problem but some breads made with spelt flour (Ancient Grains and Healthybake, for instance) are low in FODMAPs. This is because fructans – one of these indigestible carbs – gets broken down in the manufacturing process, she adds. Low FODMAP eating can be harder on vegans for whom high FODMAP beans and lentils are a good source of protein, iron and zinc. “But you don’t have to cut legumes out entirely everyone with IBS has a different threshold of how much fermentation their gut can handle before the nerve endings start screaming,” says Shepherd. The trick is to be scrupulous about avoiding other high FODMAP foods so you can tolerate some legumes. It’s best to eat just small amounts of legumes, ideally spread throughout the day – two small serves of legumes over lunch and dinner is easier on a sensitive gut than one generous serve at dinner, for instance.

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Irritable Bowel Syndrome

Research Digestive Disorders

Studies using balloons to distend the colon have shown that patients with IBS experience pain and feel bloated at balloon pressures and volumes that are significantly lower than those that cause symptoms in people without the condition. Recent studies also have shown that neurotransmitters, chemicals that pass signals between nerves, are particularly active in the gastrointestinal tracts of people with the condition. One neurotransmitter in particular, serotonin, appears to be especially active in the blood and colon of people with IBS. These high levels of serotonin may stem in part from life stresses: The colon has many connections to the brain and central nervous system, which responds to stress and emotional upsets. And more than half of patients seen by a physician for IBS report stressful life events just before or at the same time as the onset of symptoms. Infection may also play a role in the causation of IBS. The theory is that infections of the intestinal lining prompt an immune-system response that makes the intestine hypersensitive. Some people who report IBS-like symptoms actually have mild celiac disease. People with celiac disease can’t digest gluten, a protein in wheat and other grains. When exposed to gluten, their immune systems damage the small intestine. Doctors can use a blood test and/or biopsies from the intestines to determine whether a person has celiac disease. Risk factors Since doctors don’t know what causes IBS, it’s hard for them to pinpoint risk factors for the disorder. Still: Women are far more likely to be affected than men (60 to 70 percent of patients are women). Recent life stresses may put people at risk. More than half of patients who are seen by a physician for IBS report stressful life events coinciding with or preceding the onset of symptoms. Previous colonic infection Last reviewed on 7/28/09 U.S.

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Irritable bowel syndrome

Accessed June 7, 2011. Irritable bowel syndrome (IBS). The Merck Manuals: The Merck Manual for Healthcare Professionals. Accessed June 7, 2011. Wald A. Treatment of irritable bowel syndrome. Accessed June 7, 2011. Wald A. Pathophysiology of irritable bowel syndrome. Accessed June 7, 2011. Videlock EJ, et al.

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Changes for the better: a diet to treat irritable bowel syndrome

These are fermentable oligosaccharides, disaccharides, monosaccharides and polyols, found in everything from apples and wheat to garlic, onions and milk. Shepherd says there has been a marked increase in the number of people she sees suffering the effects of IBS. “People are a bit happier to talk about their symptoms these days,” she says. The 38-year-old now gets emails from across the world from people who say the FODMAP diet has changed their lives for the better. She recalls how a client had ambitions to be a professional golfer, and has only just returned to the course after years of being unable to complete a round because of IBS. Shepherd says the 150 meals inside Low FODMAP Recipes are easy to make and delicious. “It’s an everyday cookbook, people don’t need to be a gourmet chef,” she says. “I like to show people more of what they can have than what they can’t have.” There are even versions of classics such as lasagne – without trigger foods such as onion, garlic or milk. “There’s no essential nutrients that are missing – if anything, it makes cooking easier.” Shepherd has also reworked recipes that were published in previous books Irresistibles for the Irritable. “The recipes need refreshing as we’re always finding out more – like we never used to know mushrooms could cause problems, so I’ve had to tweak them out of the recipes.” Shepherd advises those who think they may have IBS to see a dietitian for individual advice. Low FODMAP Recipes by Dr Sue Shepherd, Penguin, $35.See . BARBECUED SALT AND PEPPER SQUID WITH GARDEN SALAD Have you seen this dish at restaurants and wanted to try it at home? It isnt hard to do. Just grab a few fresh ingredients and follow Sue Shepherds recipe.