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Article: Irritable Bowel Syndrome: Why the heavy burden? - by Dr. Phil Hariram |
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The current burden of Irritable Bowel Syndrome is
enormous. In USA alone there are over 40 million Irritable Bowel Syndrome
sufferers. If IBS were a condition like Diabetes, Heart disease or
Respiratory disease, then there is a base upon which to find out why and
how. In Diabetes it is clearly the body’s inability to maintain blood sugar
balance. In Cardiac and Respiratory disease, there are specific factors that
dictate the development of symptoms and outcome. This is not the case in
irritable Bowel Syndrome. In Irritable Bowel Syndrome there is no abnormality. All tests carried out before a diagnosis is established are normal. In fact the diagnosis of Irritable Bowel Syndrome is made by excluding serious gut disease. So why is it, in relation to total health cost, Irritable Bowel Syndrome ranks higher than Asthma and compares well with hypertension and heart disease? Why is it that Irritable Bowel Syndrome ranks second only to the common cold as the commonest cause of absenteeism from work? It makes you wonder why Irritable Bowel Syndrome, a condition with no structural abnormality, no real cause and one that leads to no serious illness, cost so much and cause so much distress. There is no cure for IBS. Only in few cases it goes away completely. Once diagnosed, the Irritable Bowel Syndrome sufferer knows a long life living with the problems of Irritable Bowel Syndrome lies ahead. The gut is completely normal in Irritable Bowel Syndrome. Histology from biopsies taken from the large bowel of an Irritable Bowel Syndrome patient during investigations confirms normal gut anatomy. So if the problem with Irritable Bowel Syndrome is not in the gut, where is it? Some say it is in the Brain-Gut axis. What is the Brain-Gut axis? Is the Enteric Nervous System part of it? We know that the Enteric Nervous System is connected to the Central Nervous System (Brain) and this is via the Vagus Nerve. When someone develops Irritable Bowel Syndrome, the information given is that the IBS sufferer must learn to live with Irritable Bowel Syndrome. If, however, patients develop functional illnesses related to the brain, are they told to live with it? No. Anxiety and depression are two such illnesses of the brain. Therapists do not tell anxious and depressed patients they have to live with their illness. Instead they are given counselling, cognitive behaviour therapy, hypnotherapy and various other treatments to help them overcome their illness. What do you think will happen to these patients if they were told, and they genuinely believe, that they have to live with their illness? Do you think they will get better? They will have the same problem as in Irritable Bowel Syndrome. They will be convinced there is no cure and they have to live with it. Is it not likely in such a scenario, the burden would be as great as Irritable Bowel Syndrome? Is it not also possible that the opposite advice to Irritable Bowel Syndrome sufferers will produce very different results? There are a lot of similarities between Irritable Bowel Syndrome and Anxiety and Depression. The drugs used to treat both Anxiety and Depression work in Irritable Bowel Syndrome. SSRIs (Prozac etc.) work by affecting serotonin levels in the brain. High level of serotonin is found in diarrhoea predominant Irritable Bowel Syndrome and low level of serotonin is found in constipation predominant Irritable Bowel Syndrome. Anxious patients can develop diarrhoea. Depressed patients can develop constipation. These two symptoms are cornerstones of Irritable Bowel Syndrome. Stress triggers symptoms of Irritable Bowel Syndrome. So are we getting it wrong? If there are similarities between Irritable Bowel Syndrome and Anxiety and Depression, should we not treat Irritable Bowel Syndrome just as we treat Anxiety and Depression? Should we be working with Irritable Bowel Syndrome sufferers and helping them find a way to control their IBS symptoms rather than living with them? If we adopt this method, will it reduce the heavy burden of Irritable Bowel Syndrome on the patients, the Health Professionals, and the Health Providers? Dr.Phil Hariram. |
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Dr. Phil Hariram has
been a GP for 27 years. He is a hypnotherapist and acupuncturist. He
believes the pattern of IBs depends on patients' attiutde. He is the author
of Irritable Bowel Syndrome: You take control. available at
www.healingibs.com |
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