IBD: The Disease No One Talks About

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=110 BGCOLOR="#CCFFFF" TEXT="#080000" bgproperties="fixed" background="039506e1egerbq.jpg"> <div> <FONT SIZE="5" COLOR="#339900" FACE="Arial" ><B>Post-Polio Syndrome Information and More</B></FONT><B> </B><B> </B><B> </B></div> <div> <B>                                                                                                             </B><A HREF="index_page.htm" TARGET="_top" TITLE="Index"><U><B> INDEX</B></U></A></div> </td> </tr><tr> <td valign="top" width=190 BGCOLOR="#339900" TEXT="#080000"> <bR> <div>                  <IMG SRC="1b5629c0.gif" border=0 width="98" height="156" ALT="Doctor holding an x-ray" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <IMG SRC="1e49d770.jpg" border=0 width="157" height="119" ALT="Scooter with toilet" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> </td> <td valign="top" height=370 BGCOLOR="#99CC00" TEXT="#080000"> <div> <B><IMG SRC="1b15a280.gif" border=0 width="90" height="40" ALT="New in Pink on Black" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">                                                              <IMG SRC="1b250500.gif" border=0 width="80" height="80" ALT="Bookmark me" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">        </B></div> <div> <B>IBD: The Disease No One Talks About</B></div> <div> <B>Why Americans aren't getting help for a chronic condition that's painful, limiting and can ruin their sex life. By Amy Zintl</B></div> <div> <B>Q:</B><FONT SIZE="2" COLOR="#000000" FACE="Arial" >  </FONT><FONT SIZE="4" COLOR="#0000FF" FACE="Arial" ><B>What medical disorder affects 30 million people, yet is so </B></FONT></div> <div> <B>embarrassing that two thirds of sufferers don't tell their </B></div> <div> <B>Doctors?                     </B></div> <div> <FONT SIZE="6" COLOR="#000000" FACE="Arial" ><B>A• </B></FONT><B>Irritable bowel syndrome or </B><FONT SIZE="4" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B>,</B><B> a condition that causes debilitating abdominal pain and bowel dysfunction. Many of the people who have it-</B><B>70 percent of whom are women-say they decline social invitations, pass up job opportunities and limit travel because of their condition. In fact, </B><FONT SIZE="4" COLOR="#FF33CC" FACE="Arial" ><B>IBS</B></FONT><B> </B><B>is a leading cause of absenteeism from work, second only to the common cold.</B></div> <div> <IMG SRC="1bf8b050.gif" border=0 width="139" height="5" ALT="Short rainbow line " ALIGN="BOTTOM" HSPACE="0" VSPACE="0">        <IMG SRC="1c08b050.gif" border=0 width="139" height="5" ALT="short rainbow line" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">        <IMG SRC="1c18b050.gif" border=0 width="139" height="5" ALT="short rainbow line" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" >    </FONT><B> In February 2000, many women finally found relief from their symptoms with Lotronex, the first drug for </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>IBS</B></FONT><B> approved by the FDA in two decades. Since then, Lotronex, approved only for women with diarrhea-predominant </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B>,</B><B> has led to </B><B>54 </B><B>hospitalizations, 21 surgical procedures and at least four deaths. Those alarming findings prompted the FDA to recommend strict rules for dispensing the drug, which would allow only gastroenterologists certified by the manufacturer, GlaxoSmithKlein, to prescribe Lotronex.  Rather than meet those regulations, Glaxo decided to pull it from the market in November, leaving thousands of patients without other treatment options. But there may be a silver lining-advances in </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> research that resulted in the development of Lotronex, may help experts develop safer, more effective therapies.</B></div> <bR> <div> <B>The hidden cause of lBS</B></div> <bR> <div> <B>Mysteriously, the colon of an </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>IBS</B></FONT><B> patient shows no signs of disease, inflammation or infection. But the nerves that line the colon are unusually sensitive to stimuli such as food and gas, causing irregular muscle activity and painful spasms that lead to chronic constipation, diarrhea or other symptoms, including bloating, fatigue, backache and headache. That's why experts now believe that </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> is more of a disorder of the</B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B> nervous system</B></FONT><B> than one of the stomach or colon.</B></div> <bR> <div> <B>The exact cause of this hypersensitivity remains elusive. In women, hormones may play a role, since many women report more severe symptoms during the first days of their period.</B></div> <bR> <div> <B>One theory is that for some, </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> may be an aftereffect of a previous gastrointestinal infection. "It's possible that </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>a virus or parasite</B></FONT><B> caused an infection that in some way damaged the nerves that line the colon," says gastroenterologist Susan Lucak, M.D., assistant professor of clinical medicine at the College of Physicians and Surgeons at Columbia University, in New York City. Other theories suggest that a </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>stressful or traumatic</B></FONT><B> event may trigger the disease, since </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> has been associated with </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>physical and even sexual abuse.</B></FONT><B> However, </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> is a biological condition. While symptoms often worsen in times of stress, anxiety or depression, don't let anyone tell you it's all in your head.</B></div> <bR> <div> <B>Warning signs for women</B></div> <bR> <div> <B>Unfortunately for women, </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> symptoms may be mistaken for gynecological problems. "The hypersensitivity isn't just in the bowel," says Margaret Heitkemper, R.N., Ph.D., a professor in the School of Medicine and the School of Nursing at the University of Washington, in Seattle. "As many as fifty percent of  women with </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>IBS</B></FONT><B> also suffer from painful periods, PMS, </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>fibromyalgia</B></FONT><B> and headaches." More alarming, women with</B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B> IBS</B></FONT><B> have a higher rate of hysterectomies, appendectomies and cholecystectomies (gallbladder removal). "Some women's conditions are misdiagnosed," says Lucak. "They have surgery, yet still have pain. Then they finally are diagnosed with </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B>."</B></div> <bR> <div> <B>     Those who seek medical care for </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> tend to be between the ages of 20 and 40. But getting a diagnosis can be difficult: A recent survey found that it took an average of three years and three doctors to arrive at an </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>IBS</B></FONT><B> diagnosis. If you suspect you might have the disorder, ask your doctor if he's familiar with it or if he will refer you to a gastroenterologist who is. Another survey found that only 15 percent of primary-care physicians and 60 percent of gastroenterologists knew the guidelines used to diagnose </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B>. A doctor experienced with </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> will try to rule out any other medical conditions by performing a few tests before making a definitive diagnosis.</B></div> <bR> <div> <B>New treatment options</B></div> <bR> <div> <B>          Although there's no cure for </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS,</B></FONT><B> the good news is that it doesn't lead to more serious conditions such as cancer-- and lifestyle changes can make a difference. Eating a low-fat, high-fiber diet, cutting back on dairy products, exercising regularly and reducing stress may ease symptoms. For constipation-predominant patients, taking laxatives and increasing fiber intake may alleviate symptoms, while antidiarrheals and antispasmodics are often prescribed for diarrhea-predominant patients.</B></div> <bR> <div> <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><B>     </B></FONT><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>Experts now suspect that </B></FONT><B>serotonin</B><FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><B>,</B></FONT><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B> a hormone that's known for its mood-boosting effects in the brain, may play an important role in stimulating the nerves in the colon. </B></FONT><B>(Ninety-five percent of the body's serotonin is produced in the intestines, only </B><B>5 </B><B>percent in the brain.)</B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B> That could be why some patients have found pain relief by taking small doses of antidepressants, which reduce sensitivity of nerves in the bowel. "But even at low doses, these drugs may have side effects, such as weight gain and sexual problems," says Lucak.</B></FONT></div> <bR> <div> <B>     By targeting a drug's effects on the colon, however, new medications may work without side effects. Lotronex was the first drug to block serotonin through a receptor site in the colon called 5-HT3, thereby reducing bowel sensitivity and decreasing diarrhea urgency and pain. While experts debate whether Lotronex will make a comeback, they hope that other 5-HT3 blockers will be developed.</B></div> <bR> <div> <B>     In the meantime, drugs that affect a different receptor site are being studied. One mimics the effect of serotonin through the 5-HT4 receptor site to stimulate bowel function and relieve constipation. Called tegaserod, it is also drawing controversy because it may be associated with the formation of ovarian cysts. It could be on the market as early as summer.</B></div> <bR> <div> <B>     Until these drugs are available, patients can only control, but not treat, their condition. A recent survey found nearly a third have tried stress-reduction techniques or alternative medicine, with varying degrees of success. While large-scale research of herbals and </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> </B><B>has yet to be done, some smaller studies show promise.</B></div> <bR> <div> <B>     Despite the absence of a cure, doctors urge people with </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> symptoms to put aside their embarrassment and seek care, since this might prevent a mild case of </B><FONT SIZE="3" COLOR="#FF33CC" FACE="Arial" ><B>lBS</B></FONT><B> from becoming more severe. "Women need to know what they have and what their options are," says gastroenterologist Lin Chang, M.D., associate professor of medicine at UCLA School of Medicine. "They don't have to suffer in silence." </B></div> <div> <I><B>Amy Zintl, Ladies' Home Journal, June 2001</B></I></div> <div> <I><B>The emphasis in the above article are those of the webmaster.</B></I></div> <div> <IMG SRC="1b931340.gif" border=0 width="49" height="52" ALT="smiley kiss" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">                   <IMG SRC="1ba31340.gif" border=0 width="49" height="52" ALT="smiley kiss" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">                            <IMG SRC="1bb31340.gif" border=0 width="49" height="52" ALT="smiley kiss" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> <B>Latest Update:  A simple 10 day course of antibiotics can reduce or even eliminate symptoms of Irritable Bowel Syndrome.  This breakthrough research was done at Cedars-Sinai Medical Center in Los Angeles.  Researchers found that an excessive buildup of bacteria in the small intestine is the cause of the ailment, and that antibiotics can zap those germs.  </B></div> <bR> <div> <B>"This is the first study to demonstrate that complete eradication of small intestinal bacterial overgrowth improves the symptoms of IBS -- especially bloating, diarrhea and abdominal pain," said Dr. Henry C. Lin, director of the Cedars-Sinai GI Motility Program.</B></div> <bR> <div> <B>A 10 day course of common antibiotics like Flagyl or Vibramycin, reduced levels of small intestinal bacteria overgrowth and provided dramatic relief.</B></div> <bR> <bR> <div> <B>That's all for now folks, more to come later.</B></div> <div> <B>  <IMG SRC="1dd04c80.gif" border=0 width="260" height="200" ALT="Cat waving paw" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> <bR> <bR> <div> <A HREF="id29.htm" TARGET="_top" TITLE="Easter Seals"><U><IMG SRC="0816e5a0.jpg" border=0 width="110" height="90" ALT="Back button of same cat under blanket reaching for ball" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A>                                                                    <A HREF="pps_task_force.htm" TARGET="_top" TITLE="Mia Farrow, Polio Survivor, Speaks"><U><IMG SRC="08a6e590.jpg" border=0 width="110" height="89" ALT="Forward Button of cat under a blanket with paw reaching for ball" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> <bR> <bR> <bR> </td> </tr></table></body>