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About William
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What You
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Table of Contents

Introductory
Chapter
(with images)

Introductory
Chapter
(without images)

Irritable Bowel
Syndrome
Resources

Testimonials

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The Mind-Body
Connection Series

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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

  • Lump in the throat
  • Trouble swallowing
  • Chest pain
  • Heartburn, Indigestion
  • Nausea
  • Vomiting
  • Gas
  • Abdominal pain, bloating and swelling
  • Pain in the pelvis, rectum, or anus
  • Constipation
  • Diarrhea
  • Bowel incontinence
  • Mucus in the stool

  • 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

    Functional GI disorders are very common and affect approximately 35 million 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, 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-rays, endoscopy, 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 through3, but here is a brief description:

    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 IBS have enhanced sensation and perception of bowel function. They can feel things in their GI tract, chest, abdomen, and rectum that people without IBS cannot. Doctors call this "disturbed visceral nociception." Another way of looking at this is that patients with IBS 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 activateor "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-GutConnection.

    Gut Triggers

    • Foods
    • Dietary substances
    • Caffeine
    • Inflammation and infection
    • Drugs and medications
    • Hormones (menstrual cycle)
    • Seasonal changes
    • Stress
    • Psychological problems

    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 bidirectional: it is a two-way street. The gut affects the brain, and the brain affects the gut.


    THE BRAIN-GUT CONNECTION

    Stress

    Psychological stress or emotional responses to life stress can influence GI function in anyone through the Brain-Gut Connection and produce GI symptoms such as pain and altered bowel function. But people with a functional GI disorder such as IBS are more likely to experience symptoms which are more severe and occur more frequently.

    Psychological Disorders

    Studies now show that patients with IBS and other functional GI disorders who see doctors for the symptoms are more likely to have psychological problems than are people with the symptoms who do not consult with a doctor about them. This means that psychological disorders such as anxiety, panic,depression, somatoform disorders (unexplained bodily symptoms), a history of abuse (mental, emotional, physical, or sexual), alcohol or substance abuse, or an eating disorder can lead to increased symptoms and illness and reduce the person's ability to cope. Psychological problems are not the cause of the functional disorders. Instead, such problems increase the need to consult with doctors, which leads to more testing, procedures,and sometimes unnecessary surgery.

    Psychological Consequences of Having
    a Functional GI Disorder

    Any chronic illness, including one of the functional GI disorders, can have significant psychosocial consequences such as:

    • Reduced sense of health and well-being
    • Constant concerns related to cause of the symptoms and how to control them
    • Problems with activities of daily living
    • Problems with interpersonal relationships with family, friends, and co-workers
    • Disability with missed work days. Remember, IBS is the second leading cause of industrial absenteeism in the United States.

    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.


    BODILY SYMPTOMS: SOMATIZATION AND THE "IRRITABLE BODY"

    • Painful, tender muscles (fibromyalgia)
    • Fatigue and low energy
    • Insomnia
    • Headaches
    • TMJ (pain in the jaw)
    • Dizziness
    • Feeling faint
    • Difficulty concentrating
    • Shortness of breath
    • Chest pain
    • Abdominal pain
    • Back pain
    • Pelvic pain
    • Painful menstrual periods
    • Decreased sex drive
    • Bladder problems


    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).


    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 physicianis 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 disordersis integrated with holistic Mind -Body concepts and the latest informationon 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. 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

    • Understanding the GI tract and "The Connection"
    • Reviewing Functional GI Disorders
    • Healing with Diagnosis and Education
    • Making "The Connection"
    • Identifying Gut "Triggers"
    • Emphasizing Self-Care and Wellness
    • Taking Action If Symptoms Persist
    • Managing Your Functional GI Disorder(s)

    Use your problem and illness to change your life and health.
    Welcome to wellness!



    William B. Salt II, MD
    Columbus, Ohio


    PROFESSIONAL MEMBER



    International Foundation For Functional
    Gastrointestinal Disorders (IFFGD)