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Introduction:
Here is Your Prescription for Change!
(There are over 120 illustrations, pictures and tables in the finished book.)

You always had it.
You always had the power.
- GLINDA, the Good Witch in The Wizard of Oz


If you have Irritable Bowel Syndrome (IBS) or one of the other functional gastrointestinal (GI) disorders, or suspect that you might, then this book is for you. Many people with ulcerative colitis and Crohn's disease, the two forms of inflammatory bowel disease (IBD), and many with diverticulosis also have IBS. If you have one of these conditions, then this book can help you, too.

IBS is a major public health topic and receives much media attention in newspapers, magazines, radio and television. Many people recognize the acronym "IBS" and terms like "spastic colon," "spastic colitis," "mucus colitis," and "nervous stomach." You will be hearing more and more about this common and troublesome condition, as well as about the other functional GI disorders.


WHAT ARE FUNCTIONAL GI DISORDERS?

They are defined as "variable combinations of chronic or recurrent GI symptoms not explained by structural or biochemical abnormalities." This means that even after performing blood tests, taking x-rays, and examining the digestive tract with endoscopes, doctors cannot find a cause. There are 25 of these disorders, and many people have more than one. Symptoms can come from nearly all parts of the GI tract.

You will learn to manage your disorder(s) in Step 8 of this book. But before then, you will understand how much in common all of these disorders really have in terms of cause and treatment.


SYMPTOMS OF IBS


WHAT IS IBS?

IBS is the most common functional GI disorder. The symptoms come from the colon and include abdominal pain and bloating, as well as disturbances in defecation (the process of having a bowel movement). These symptoms are diarrhea, constipation, and diarrhea which alternates with constipation. The stool form (bowel movement) is often altered, being lumpy and hard or loose and watery. Stool passage can be affected with straining at having a bowel movement, urgent need to find a bathroom, or a feeling of not having emptied the rectum. Passage of mucus in the stool is also common. The symptoms can be continuous or intermittent.


MILLIONS OF PEOPLE ARE AFFECTED

One in FiveFunctional GI disorders are very common and affect approximately 35 millions people in the United States. They account for 10% of visits to primary care doctors and at least 50% of visits to gastroenterologists. Each year, 2.6 million people seek treatment for symptoms related to functional gastrointestinal disorders, and visits to physicians total 3.5 million. IBS affects nearly one out of five people in the United States including children, teenagers, young adults, the middle-aged, and the elderly. The average age of onset of IBS is between 20 and 29 years of age.


WORLDWIDE PROBLEM

IBS is prevalent throughout the world including China, Canada, the United Kingdom, Australia, New Zealand, and Scandinavia.


A COST OF BILLIONS OF DOLLARS

Studies now show that these disorders cost billions of dollars in the United States each year in visits to doctors, diagnostic testing, and treatments. Furthermore, since IBS is the second leading cause of industrial absenteeism, loss of work days is costly to companies and employers, as well as to people with the disorders.


WHAT CAUSES THESE DISORDERS? 

We know that these conditions are not caused by infection, inflammation, or blockage. In fact, evaluation with X-raysendoscopy, and blood testing usually fails to show any abnormality. But the symptoms are very real! What is causing them?

You will learn what you need to know about the causes in Steps 1 through 3, but here is a brief description:


THE BRAIN-GUT CONNECTION

IBS and other functional GI disorders cause symptoms and discomfort ranging from mild and inconvenient to severe, resulting in incapacitation and disability. Current evidence shows that many people with IBS lead restricted lives in multiple areas: diet, social activities, and energy level, without much relief from current health-care practices and medications.


THE MIND-BODY CONNECTION: THE "IRRITABLE BODY" AND SOMATIZATION

Just as the GI tract is unusually sensitive and irritable, many people with IBS and other functional GI disorders seem to have a sensitive "irritable body", or what doctors call "somatization".

As in IBS and other functional GI disorders, these symptoms are associated with normal test results and cannot be explained by any specific disease process. Disturbances in the Mind-Body/Brain-Gut Connection account for much of the trouble.


THE MIND-BODY/BRAIN-GUT CONNECTION: THE VICIOUS CIRCLE OF STRESS, PSYCHOLOGY, AND SYMPTOMS

The "fight-or-flight" response by the body in response to perceived stress results in an increase in blood pressure, heart rate, breathing, and metabolism (Chapter 5). With continued or unrelieved stress, the body can become unbalanced and unable to recover, leading to the physical symptoms listed. The emotional responses to these unexplained symptoms and fear of not knowing when the symptoms will start can actually make them worse. A vicious circle of stress, psychology, and symptoms can be established (Chapter 6).


BODILY SYMPTOMS: SOMATIZATION AND THE "IRRITABLE BODY"


HEALING THROUGH THE CONNECTION

You will see how to use your mind to take control and reduce or eliminate the symptoms of IBS or other functional GI disorders. You can learn to manage the symptoms of the "Irritable Body." You will be able to recognize and manage stress and psychological problems. You will know how to live a healthy lifestyle. Finally, you will appreciate how spirituality can contribute to your healing.

IBS VERSUS COLITIS AND INFLAMMATORY BOWEL DISEASE (IBD)

The term "colitis" refers to colon inflammation and should not be used to refer to IBS, because in IBS the colon is not actually inflamed. However, inflammation is found in several important disorders called inflammatory bowel diseases (IBD). The two types of IBD are ulcerative colitis, which affects the rectum and colon, and Crohn's disease, which can involve both the colon and the intestine. Nearly 1 million Americans suffer from IBD. Although the treatments for IBS and IBD differ, many people with IBD also have IBS and can benefit from the treatment advice in this book.


WHAT ABOUT DIVERTICULOSIS?

Diverticulosis is a very common disorder in which pockets develop in the colon because of increased colon spasm and pressure. Although the cause of this process is not really known, many people with diverticulosis have the same symptoms as do those with IBS and can also benefit from this book.


WHY A BOOK ABOUT THESE PROBLEMS?

There have been many new developments in the diagnosis and treatment of IBS and other functional GI disorders. Furthermore, there is an increasing awareness of our abilities to heal by leading a healthy lifestyle and utilizing newer understanding of the Mind-Body/Brain-Gut Connection. As an MD and board-certified gastroenterologist with more than 20 years of experience caring for people with IBS and other functional GI disorders, I will provide you with the information you need.

Trends toward "managed care" will make it harder for your doctor to spend time with you. In fact, most doctor visits are now limited to 12 minutes or less! This isn't much time for a patient to understand diagnosis and treatment. Also, it is becoming more difficult to gain access to a medical specialist because managed care expects that your primary care physician (family doctor) will be able to handle most problems. The model of interaction between the patient and the primary care physician is shifting so that you, the patient, are given more responsibility in the management of your health care. You will need accurate and reliable information in order to fulfill this responsibility and opportunity. That's where this book will help.

You can learn to be healthy. Accurate information leads to healing and is often more important than medication. With this book, you can explore your diagnosis and treatment options in the privacy of your home and on your own time. Then, armed with information and knowledge about your problem, you will be better able to partner with your doctor to heal.

The focused information here on IBS and other functional GI disorders is integrated with holistic Mind -Body concepts and the latest information on living a healthy lifestyle. The logical 8-step approach can be completed over a 12-week period.


CHANGE: WHY 12 WEEKS?

It will take you 12 weeks to read this book and walk through the 8 steps (see Table 4). Change is not easy, but neither is living with IBS and the other functional GI disorders. Behavioral psychologists have studied people who have been successful with change. These studies show that it takes about 12 weeks to make the commitment, begin to change behavior, and establish the pattern.


AN 8-STEP, 12-WEEK PLAN FOR LIVING A HEALTHY LIFE WITH A FUNCTIONAL BOWEL DISORDER OR COLITIS


Use your problem and illness to change your life and health.
Welcome to wellness!
William B. Salt II, MD
Columbus, OH

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