CAUSES THESE DISORDERS?
We know that these conditions
are not caused by infection, inflammation, or blockage. In fact, evaluation
with X-rays, endoscopy, and blood testing usually fails to show any
abnormality. But the symptoms are very real! What is causing them?
1. Disturbances of the normal
activity and function of the digestive tract
The normal movement of food contents through the digestive tract depends
upon motility, or peristalsis, which is the rhythmic and orderly muscular
contraction of the gut. A disturbance in normal motility and peristalsis
causes symptoms like cramping abdominal pain, diarrhea, constipation,
and relief of pain with the passage of loose bowel movements.
2. Increased sensitivity to
what is happening in the gut and abdomen
Many people with irritable bowel syndrome have enhanced sensation and
perception of bowel function. They can feel things in their GI tract,
chest, abdomen, and rectum that people without irritable bowel syndrome
cannot. Doctors call this "disturbed visceral nociception." Another
way of looking at this is that patients with irritable bowel syndrome
and other functional GI disorders have lower internal pain thresholds
for reasons which are not understood.
3. Gut reaction to "triggers"
This sensitive GI tract can have a hyper-reaction to things that activate
or "trigger" pain and symptoms. You will learn how to identify, control,
and eliminate these triggers in Step 5. Stress and psychosocial problems
are not only triggers, but are also integrated into the Mind-Body/Brain-Gut
TABLE 1 Gut Triggers
4. Problems related to the Brain-Gut Connection
The Mind-Body/Brain-Gut Connection is the key to understanding these
disorders and to the healing process, and you will study it throughout
the book. There is a powerful "connection" between the mind and
the body/gut. Gut sensations reach the brain through the circuitry
of nerves in the wall of the intestine, then to the spinal cord,
and finally the brain. Transmission is bi-directional: it is a two-way
street. The gut affects the brain, and the brain affects the gut