curing ibs

Dr. Stephen WangenNow I am finally feeling like I thought I should. Even more than the treatment, I was glad that I went to the IBS Treatment Center simply because they were the first people to really listen to me and treat me like I was telling the truth. My gastroenterologist actually apologized to me because he hadn’t taken me seriously.

The IBS Treatment Center, on the other hand, was very supportive and seemed to really care if I got better. When I had an appointment, they were not trying to rush me in and out, and were willing to listen to my symptoms and look for a cause rather than handing me a prescription to get me out.

I have been so impressed that I have recommended them to several of my friends, who have all had good things to say. One of my friends called me after leaving their office and she was crying because someone actually believed her. Before seeing them, she had been told by her doctor that her symptoms were “all in her head” and had actually been referred to a psychiatrist! Now her symptoms have improved tremendously.

I would recommend them to anyone who feels sick and doesn’t know why. They will really work to find the problem!

Thanks,
Sarah

IBS Specialist and Gastroenterologist

IBS specialists are experts in irritable bowel syndrome (IBS). A gastroenterologist may diagnose IBS, but that will only tell you what you already know, that your bowel irritates you.

IBS specialists do not do what gastroenterologist do, and gastroenterologists do not do what IBS specialists do. These are completely different specialties. There is only a very tiny amount of overlap with regard to stool testing. But even this is extremely minor as the IBS specialist utilizes much more advanced stool analyses.

To the IBS specialist the label of IBS only serves as a starting point for further investigation, nothing more. The IBS specialist focuses on assessing and diagnosing the cause of your digestive problems, not on the gross structural integrity of the digestive tract. Rather than focusing on the patients symptoms, or simply treating the symptoms, the IBS specialist is devoted to identifying the condition or conditions in the patient that are causing the symptoms.

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A great letter from a former patient.

“In the third grade I remember complaining constantly about having stomach aches and was actually put on anti-anxiety medication. I have struggled with this throughout my 52 years.

Things really got bad about 6 years ago when I started having severe stomach aches along with bloating and large, really smelly bowel movements.

After having every test known to man, with no serious problems found, I was diagnosed with IBS. I started feeling depressed, withdrawn, tired and sick ALL THE TIME.

A friend told me I should go to the IBS Treatment Center. I called the next day and made an appointment. One of the best decisions I have ever made! Thank you, I LOVE YOU!!!!”

– Susan Weir (former patient of the IBS Treatment Center)

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Most physicians are trained to think of IBS as stress induced or as a type of psychosomatic disorder.

There has not been an easy medication cure for IBS, therefore it has been framed in a way that suggests that it is more your problem than the physicians. Although some cases of IBS are no doubt related to mental or emotional issues, and stress and anxiety can aggravate IBS (as well as most other medical conditions), they are not the predominant causes of IBS. More often, IBS causes you stress rather than the other way around.

One excellent recent example of this is stomach ulcers. While stomach ulcers were once thought to be a stress-induced disorder, it is now well accepted that the bacteria Helicobacter pylori cause them, and that they are treatable.  Interestingly H. pylori can also cause IBS symptoms, and now that we can test for it and treat it, there is one more reason to believe that stress is too often blamed.

It’s true that stress can make the symptoms of IBS worse, and that your digestive system depends on relaxation to function properly. Occasionally stress is the sole cause of IBS. But far more often it is due to something else. If you still have symptoms when you know that there isn’t much stress, then there is more to the problem than stress!

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Dr. Stephen WangenDigestion should be the natural process of an exquisitely complex system that converts food into the materials needed for life: vitamins, minerals, fats, amino acids (proteins), and sugars (carbohydrates). From the average person’s point of view, it is a relatively easy, even unremarkable process, something you take for granted. But from a medical viewpoint it is truly fascinating.

A lot happens between the time you eat a piece of food and the time the waste products leave your body. Most people are concerned only with the two parts of the digestive system that require some active participation on their part – the food going in and the waste coming out. The steps between these two poles are involuntary, and you probably don’t pay a lot of attention to them, or need to, as long as things are working well.

Elimination itself is fairly straightforward. Eating causes the colon to contract, beginning the process of peristalsis: contraction followed by relaxation, over and over again along the tube, moving things down to the exit. Between thirty to sixty minutes after eating (depending on various factors, such as how much was in the intestinal tract to begin with), a person will normally feel the urge to have a bowel movement.

About 60% of the fecal mass is made up of water, although this figure can vary widely. When you have diarrhea, for example, the percentage of water is much higher. About 30% of a normal stool consists of dead bacteria, which gives feces its characteristic odor. The rest is made up of indigestible fiber, fats (such as cholesterol), inorganic salts, live bacteria, dead cells and mucus from your intestinal lining, and protein.

Relaxation is a key to healthy bowel movements. In fact, the whole of digestive function is based on relaxation. This is why stress is often blamed for bad digestion. When you are relaxed, the parasympathetic part of your nervous system is dominant. This same part allows your digestive system to “do its thing.”

Although the number of bowel movements a day that is considered “normal” varies, the average is one or two. Stools should be well formed; not watery; generally dark brown in color; and passed easily, without straining, cramping, or pain. Lighter brown stools, which usually float, generally mean you’re not digesting fats very well. Ideally, at the end of the bowel movement you should feel like you are fully “through.”

Evacuation is a fine balance and everyone is a little bit different, but the general rule is that if you experience discomfort, especially regularly, then things are not functioning normally. Pooping is a natural experience and should be comfortable and – dare we say it? – even bring an enjoyable feeling of release.

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From a recent patient of the IBS Treatment Center.

I always had a nervous stomach my whole life, but it was nothing serious until part-way through college when I started having some major digestive problems.

I was beginning to feel like I was falling apart, and my anxiety worsened as my symptoms worsened. But most of the time I thought the anxiety was causing the symptoms and I was just trying to live with it.

I always had an escape route to the nearest bathroom scouted out. I saw several conventional doctors [who couldn’t help me], so I decided to see a gastroenterologist. He told me that there’s not much that can be done about it. He told me to reduce my stress, and gave me a list of foods to eat that are rich in fiber. I tried these things, but it hardly made any difference.

So I turned to alternative medicine and tried homeopathy, supplements, acupuncture, and an elimination diet…but none of those worked either. I did some more research and found the IBS Treatment Center online. I decided to take the chance, and I am so glad I did.

I’ve been telling people that it was the best money I’ve ever spent! I was so impressed with the whole operation.

-Amanda McLean

Learn more about the IBS Treatment Center here.

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gI_SignImage.jpgWe received the following letter from a recent patient.

It is truly amazing that with all the research on this subject, (including double-blind & placebo controlled studies), that widespread testing for food allergies is still not done.

Dr. Wangen,

When I came to see you for migranes I felt as though I was making a “last ditch” effort. I had suffered from headaches since I was about 12 years old and the preceding 3 years had become unbearable. At the time I saw you I had had the same headache for about 8 months. I was miserable. (The headache before that had lasted 18 months!)

Many times over the years I had asked various healthcare providers if something I was eating was making me sick. EVERY single one of them told me that food allergies do not cause migraines. And yet that was the first thing you tested me for! The three weeks I waited for my blood test results seemed like forever. When the test results did come back they showed that I was highly reactive to dairy, eggs, and sesame and reactive to other foods as well though not as severely. I left your office a bit overwhelmed and wondering how on earth I was going to eat. I had a good cry in the car and then stopped for a cheese burger on a sesame seed bun on the way home. Then I cried again. My tears were in part because I felt so consumed by this new information, and in part because I finally had a possible new solution to ridding myself of the constant pain.

After that final cheeseburger I never looked back. I eliminated every single item that my blood testing indicated could be a problem. Of course it was a huge challenge at first to change my diet so drastically. But it proved to be absolutely worth it. After about 3 weeks my headaches started to lessen.

It wasn’t every day anymore.

After about 5 weeks I felt significantly better. That was all I needed to keep me going! My son (aged 8) noticed that mommy was more “fun.” He commented about how good it was that I wasn’t always in bed. Heartbreaking for me to hear, but he was right.

For a long time I was committed to the new diet and I did not stray from it one tiny bit. I eventually decided to try one of my old favorite foods. I quickly learned that my digestive system no longer tolerated eggs and dairy and the next day I had a headache which lasted for 5 days. This seems to be a predictable pattern as I have tried a few other foods in the past 6 months. At this point I am not interested in trying to add back any of the foods which I tested positive for (although I may consider having some Creme Brulee on my birthday in August…).

My headaches are not entirely gone. But now I know any new headache will only last a day, maybe 2, and then it will end. I previously had headaches that didn’t have endings. Knowing that any headaches now will end makes it much easier to cope.

When I think about the time and money spent over the years on EEG’s, MRI’s, CT scans, a cabinet full of prescription drugs, biofeedback, and more I want to scream! My neurologist at that time told me that there was nothing more he could do for me, he didn’t need to see me again.

All this to tell you how much I appreciate you! Previously, I couldn’t imagine the migraines would ever end, and yet they have! I appreciate everything you have helped me with. THANK YOU!!

Sincerely,
Darcie

While we focus on IBS (Irritable Bowel Syndrome), it is amazing how many other health problems are related to immune system food reactions and other digestive issues. If you would like to read more about the science behind food allergies and headaches, check out links at the Food Allergy and Intolerance Foundation and these studies:

Alpay et. al. (2010). Diet restriction in migraine, based on IgG against foods: A clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 July; 30(7): 829–837.doi: 10.1177/0333102410361404. [Full Text]
and

Arroyave Hernández et. al. (2008)
. Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex. 2007 Sep-Oct;54(5):162-8.

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Drugs for IBSThe typical medical approach for treating Irritable Bowel Syndrome (IBS) involves either doing nothing, or guessing at the problem and trying different medications.

Many of the patients that come to the IBS Treatment Center have been on numerous medications. None of which has solved their problem (or they wouldn’t be in our clinic in the first place!), and most of which were not designed to treat IBS symptoms. Types of medications often prescribed for IBS include:

These drugs may be prescribed as a best guess, in the hopes that the patient will experience some relief. Research continues on IBS medications, but most of the time medications fail to cure the majority of patients.

There is no single cause for IBS, and there will never be just one treatment that works for everyone.

At the IBS Treatment Center we rarely use any of these medications. Other than antibiotics for bacterial overgrowth, the medications listed above have clearly demonstrated their inability to cure IBS.
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This article is titled “Brain imaging to identify physical reasons why IBS symptoms improve with drug-free treatments.”

No doubt that they’ll find that people who feel better have measurable changes in their brain activity.  That would be true for any issue.

But to imply that it is identifying the cause of the problem is misleading. People can treat pain without drugs, but that doesn’t mean that they’ve addressed the cause of the pain. The pain is still a symptom. 

In my opinion the $8.9 million that is being spent could be put to much better use examining the causes of the IBS, not the symptoms. The gut-brain connection that they and others often mention is convenient but it is primarily the gut driving the brain, not the other way around. Stress and anxiety will exacerbate the problem, but they make everything worse,  not just IBS. Something else has to be making the digestive tract weak and therefore susceptible to stress. Focusing on those issues is the key to curing IBS.

-Dr. Stephen Wangen

Excerpt from WNYPapers.com:

“We’re going to look at biological mechanisms that underlie these non-drug treatments, to discover what is going on in the brain that explains treatment benefits achieved by teaching patients specific skills to control and reduce their symptoms,” said Jeffrey M. Lackner, Ph.D., associate professor of medicine at the UB School of Medicine and Biomedical Sciences and a project principal investigator. “By using a brain scan to compare brain activity before and after treatment, we expect to get a picture of changes in the brain that correspond to improvements in gastrointestinal symptoms.”

It continues…

“We’re excited about the possibility of providing the first evidence for biological markers that correlate with treatment-induced symptom changes, and developing a better understanding of the mechanism behind IBS,” Lackner said. “Such cutting-edge translational research is going to help foster individualized, specific treatments for patients.”

One treatment developed at UB aims to control symptoms by changing specific thinking patterns and behaviors found to aggravate IBS. Using state-of-the-art brain-imaging methods, UCLA researchers, under the leadership of Emeran Mayer, MD, hope to identify the biological mechanisms underlying their effectiveness. Mayer is a professor of medicine and psychiatry at UCLA, director of the Oppenheimer Center for Neurobiology of Stress and principal investigator of the imaging study.

Scientists believe that IBS symptoms are the result of dysregulation of brain-gut interactions, resulting in abnormal muscle contractions in the gut and heightened sensitivity to painful stimuli.


Image thanks to worcesterparents.org

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(image thanks to thedancingbibliophile.blogspot.com)

This came up in the news recently and is worth noting.

From MedicalNewsToday.com:

“GENIEUR, which stands for Genes in Irritable Bowel Syndrome Europe, was funded by the European Science Foundation. Its main aim is to identify the genes and DNA variants which might be linked to a higher risk of developing IBS symptoms.”

“According to health authorities in Sweden, IBS is the second most common cause of work absenteeism, after common colds – over 10% of all Swedish adults live with IBS.”

Having successfully treated thousands of IBS (Irritable Bowel Syndrome) patients, I am 100% confident that their approach will do little to shed light on IBS.  There are literally hundreds of causes of IBS. Therefore it is impossible to find any genetic variants that will have any  meaningful impact on patient health or patient treatment.

The same has been true for celiac disease, which is far simpler than IBS. The genetic variants that have been found in celiac disease still don’t come anywhere close to predicting celiac disease. They also don’t change the treatment for celiac disease, and they never will.

So why do scientists and doctors take this approach? 

One major reason is that they can get funding for it. In the scientific community, if you can get funding for something, then someone will do the study.

Genetic studies are sexy science right now, which is one of the reasons that funding is available. But what we continue to fail to realize is that we control our genes far more than they control us.


Image thanks to thedancingbibliophile.blogspot.com

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The biggest misconception about IBS (Irritable Bowel Syndrome) is that it defines a specific medical condition.

IBS is, by definition, just a group of symptoms affecting the digestive tract that haven’t been explained. Unlike cancer, a stroke, or the flu, IBS is more of a starting point than a diagnosis, because it doesn’t provide any new information.

Once a person has the symptoms it is necessary to do additional testing to identify the cause of those symptoms – what you might call an actual diagnosis. Once you have an actual diagnosis, then you can treat whatever it is that causes the symptoms and usually stop them.

IBS Misconception #2

A second common misconception is that IBS is only caused by one thing. Nothing could be further from the truth.

The digestive tract is very complicated, but can only display a limited range of symptoms. There are many things that can cause constipation, diarrhea, abdominal pain, gas, bloating, etc. Any individual might have one or more of the causes at any one time.

There is a wide range of causes of IBS and many patients have more than one cause, sometimes several causes, at the same time. For example, many patients have an allergy to a food, which causes them to have IBS symptoms. But not all IBS patients have food allergies.

Many patients have bacterial or microbial issues, for example, not enough of the needed digestive bacteria are living in their digestive tract. But not all IBS patients have bacterial issues. Some patients have food allergies, bacterial/microbial issues, and other factors. To correctly diagnose the cause of IBS symptoms it is necessary to test for a range of potential causes. If you don’t treat all of the conditions you have, your IBS probably won’t be resolved.
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There are many ways to trigger the immune system – infections, gut microbial community imbalances, immune reactions to foods (food allergies), celiac disease, and others.

The key to understanding Irritable Bowel Syndrome is understanding that IBS is not a single disease. There is not a single test for IBS because IBS is not a single disease. It is a set of symptoms, like fever and body aches, that can be caused by many different conditions.

In a recent article from HealthDay.com titled, “Treating Irritable Bowel Poses Challenges”, Dr. Satish Rao says that finding exactly what causes IBS remains a mystery — or what Rao called “the million dollar question.”

Excerpt:

“We have unearthed some factors,” Rao said. “It looks like people with certain genes are predisposed to IBS, and environmental factors play a role. Changes in the gut flora [the types of bacteria in the intestine] may predispose you to IBS.” He also said that some people develop IBS after having a viral or bacterial infection. That’s called post-infectious IBS.

Some people also have dietary intolerances to substances such as fructose, he said, and those symptoms can mimic IBS.

One factor that definitely does not cause IBS, Rao said, is stress — though he said it could trigger symptoms in people who already have the digestive disorder.

A specific diagnostic test doesn’t exist for IBS so to diagnose it, doctors must rule out other potentially more serious causes of digestive symptoms, such as colon cancer or Crohn’s disease. Methods used to do this, Sandborn and Rao said, include blood tests, CT scans, a hydrogen breath test, endoscopy and colonoscopy.

We know that some people have IBS because their immune system is being triggered, which results in symptoms.  There are many ways to trigger the immune system – infections, gut microbial community imbalances, immune reactions to foods (food allergies), celiac disease, and others. We have cured thousands of people with IBS by testing for and treating these issues. This is important for you to keep in mind as you read articles that discuss the “mystery” of IBS.

Image thanks to barronmind

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Drugs change how you experience IBS by forcing changes in the biochemistry of your body, but none is capable of curing IBS because it is not caused by a drug deficiency.

At least 20 million Americans have been diagnosed with IBS. Drug companies are beginning to tap into this hefty target market by offering medicines aimed at relieving the symptoms of IBS. These drugs alter the physiology and ultimately the action of the digestive tract, but they do not address the underlying causes of IBS, or even claim to cure IBS. These drugs also come with an alarming variety of warnings and side effects.
Six types of drugs are used to treat the different symptoms of IBS. They include the following:

    1.    IBS-specific drugs to control the speed with which the bowels move (Zelnorm, Lotronex, and Calmactin),
    2.    laxatives to treat constipation (such as Milk of Magnesia, Ex-Lax, Perdiem, and MiraLax),
    3.    antidiarrheal agents to treat diarrhea (such as Imodium and Lomotil),
    4.    antispasmodics to relive the pain from abdominal cramps (such as Donnatal, Levsin, Levbid, NuLev, Bentyl, and Pro-Banthine),
    5.    antidepressants to relieve pain (such as Prozac, Celexa, Zoloft, Paxil, and Elavil), and
    6.    narcotic analgesics to relieve pain (such as Vicodin, Demerol, and Xanax).
 
Note that these drugs are categorized by the type of symptom that they treat. None of them cure IBS. They change how you experience IBS by forcing changes in the biochemistry of your body, but none is capable of curing IBS because IBS is not caused by a drug deficiency.

Treatment with these drugs does not address the cause of your IBS, and once you stop using the drugs the symptoms will return. The use of these drugs often results in serious side effects and/or negative long-term consequences.

More information about these medications can be found in the book, The Irritable Bowel Syndrome Solution.