Before I get started with today's lesson, let's just dispense with the crappy puns right now. You will soon discover that it is irritating indeed to have to go running for the porcelain bowel all the time. You begin to feel behind at work. And when you seek a little bit of leeway from the powers that be, they are perhaps colon you a pain in the rump behind your back. And they would be correct, as the pain is always there. In the abdominals, mainly, however the rump is also heavily invovled. Butt you carry on valiantly and hope that some day, with the right treatment, this will all be wiped away.
Say you: Ok. What brought this on?
Say me: I'm glad you arsed.
The situation:
The woman I saw had been living with it for too long, the result of a botched episiotomy some twenty years previously. It certainly wasn't any fun for her and she had reached the end of her rope by the time we met: Wearing diapers all the time, always making sure she was close to a facility, never wearing pants, rarely going out for fear her body would betray her, sensitive to the inevitable odor, fearful her job was in jeopardy, feeling out of control and only sporadic support from her husband. She was tired. And depressed. And angry. Angry that she had been living this way for so many years and incredulous that some how, the medical establishment had yet to come up with some kind of intervention that actually worked for her.
The affliction:
Affecting 20% of the population, it all starts with abdominal pain, cramping, and bloating. Not unlike how you would feel after eating a bad oyster. Except when you eat a bad oyster, the pain is gone in 6 to 8 hours. Not so much with IBS, in which the pain is acute and the condition is chronic. Always, it ends up jacking with a person's ability to pass their stool. For some this manifests itself via diarrhea and for others, constipation.
The Cause:
Well, apparently the jury is out. There is some speculation that it could be hormone related. There is some speculation that the immune system is involved. There is some speculation the central nervous system is at play.
Allow me, if I may, to digress a wee bit. Remember Prozac? The Wonder Drug of the Nineties? It's an SSRI, also known as a Selective Serontonin Reuptake Inhibitor. Basically, this means that the drug inhibits the brain's ability to reabsorb serotonin at the receptor site. The extra serotonin floating around in the noggin improves overall mood. Ready for this? Researchers don't actually know how SSRI's work. This serotonin business is merely an excellent theory. Here's a pictorial.
Say you: Yeah. We were talking about poop...
Say me: Hang on. Segue way forthcoming.
Here's the deal: 95% of our body's serotonin is not in the brain, as one would assume, but in the GI tract! (Which would explain why there are generally, um, digestive issues, that often accompany Prozac and its cousins.) So, the theory is that people with IBS have diminished receptor activity in their intestines which means higher level of serotonin and weird stuff going on when the body is trying to absorb nutrients.
Triggers (not causes) include stress, some foods including alcohol, caffeine, chocolate (I would be screwed on this front) and other illnesses.
The Good:
This is hardly a fatal disease. Symptoms can be managed with medication, diet, managing stress, and, according to one study, cognitive behavior therapy in conjunction with "standard medical treatment". Also, for some, the symptoms only rear their heads every-so-often, so on the whole the disease is quite managable.
The Bad:
There is no cure. And need I enumerate the symptoms again?
The Ugly:
Foreign items up your rectum during the diagnostic phase. ->
Read the complete post at http://feeds.feedburner.com/~r/blogspot/tXCM/~3/389637077/irritable-bowel-syndrome.html
Posted
11 Sep 2008 11:00 AM
by
Trench Warfare
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