I was hospitalized for a flareup of IBS two years ago. The doctors told me they couldn’t let me leave the hospital until the pain stopped, or my inflamed colon might perforate and that might kill me. Yes, it’s real and it can be very serious.
Huh? We’re talking about the DSM-IV, the Diagnostic and Statistical Manual of Mental Disorders.
Last time I was hospitalized with a flare-up, my gastroenterologist didn’t seem to think it was psychosomatic. I have severe IBS and stress can exacerbate a flare-up, but it certainly isn’t the only trigger. I take a prescription anti-spasmodic (Levbid) that has helped lessen both the frequency and severity of the attacks. The meds (and anyone feel free to correct me on this) help stop the intestinal contractions.
I’ve heard an interesting, and untested, theory that IBS can begin after excessive antibiotics. My episodes began after serious gangrenous gallbladder disease and massive intravenous antibiotics. No one really knows what causes IBS and since there isn’t a a simple test for the condition, I think it’s easy for some to dismiss it as “all in your head.” I went through two ultrasounds, and MRI, a lower GI, and two endoscopies before I was diagnosed - my doctor took the situation very seriously, and my quality of life has improved tremendously.
(Apologies for the rambling anecdotal quality of my post).
Psychosomatic doesn’t mean imaginary or “all in your head,” does it? Correct me if I’m wrong, but I thought psychosomatic symptoms meant bodily reactions to mental or emotional processes. For example, I would call an increased heart rate psychosomatic if it is due to fear. Am I using the term wrong here?
I rarely actually hear the term “psychosomatic” used very much because people get the idea that it refers to the concept that there is nothing physically wrong, it’s “all in their head”. That simply isn’t true. The various somatoform disorders often display ACTUAL physical ailments and pain. Usually gastrointestinal, sexual, or neurological symptoms. The cause of these symptoms is what is in question. If the main cause of IBS (a real physical malady, complete with measurable symptoms) if the actual cause has no direct medical explanation but is more than likely the result of “worry” “stress” “anxiety” etc etc. (ie:psychological triggers) Then it would fall into the large category of somatoform disorders. Which includes hypochondriasis, conversion, dysmorphic and pain disoders.
Somatization disorders were once referred to as hysteria.
The symptoms are real allright…to the point of death even. A lot of people have died from “hysterical disorders” because the medical profession was unable to find the cause. Is that clear as mud now? 
Sorry about that 
up there. Gotta watch what characters you put together sometimes.
That should’ve been (ie. psychological triggers)
Hey, I don’t just save anyone. They have to believe. They have to tap their shoes together three times, say a little prayer, and understand that just because an MD comes from Oral Roberts University, they can be just as skilled as an accredited doctor working in a real hospital. I don’t generally tell folks my “doctorate” is a 0+i(MD).
No way. My father had it, and so do I. Fortunately, Daddy modeled behavior which some people find laughable, but I, and others, find helpful. I read in the bathroom. No “straining at stool,” - which can be dangerous, BTW.
Of course, that’s entirely absurd when you’re in diarrhea mode; you simply stay as long as you must, but a book or magazine helps you tolerate the misery. When you’re in constipation mode, making/taking time to relax and forget why you’re sitting there really helps (most people I’ve known) with this problem to reduce/avoid (depending on severity of symptoms) the use of “aids” - including, but not limited to, added fiber.
I believe there is a genetic component. I also believe that the bacterial overgrowth mentioned above is a factor. In constipation mode, the waste sets there long enough to allow massive proliferation of bacteria. However, my hypothesis (which has a scientific basis) is that chronic infection with a Clostridium species usually called C. difficile (and which I believe would be more correctly named C. philoperitoneum, because I was able to recover it from almost every site inside the peritoneums of mice which I had inoculated with it) is either a cause or a result - and I believe it’s the latter, or I wouldn’t be claiming a genetic component.
Dr. Paprika wrote: Many patients with irritable bowel, fibromyalgia, etc. do not accept that stress is the major cause.
Oh, is that so, Dr.? Let’s hear from some sufferers. . .
Exapno Mapcase: I for one am fully convinced that in most cases, however, the psychosomatic explanation has become quackery.
mouthbreather: I suffer from it pretty bad, and mine is not at all associated with stress.
cazzle: However, no matter how well I eat and how low my stress levels are, it will flare up for no apparent reason every so often.
Heart on my Sleeve: I find that it doesn’t correlate with my stress level at all
Gorilla Man: Stress is one minor factor.
tygerbryght: Irritable Bowel Syndrome - Psychosomatic? No way. My father had it, and so do I.
Honestly, I’m a little puzzled by it. My wife has it, and her Mom and sister do, too. But that doesn’t rule out that its brought on by stress. My wife used to have silly back problems too, that I think were just stress.
The way she talks about the IBS was so similar to the back stuff (which she doesn’t have anymore). There would be one thing that brought it on, and one thing that didn’t. Then, next you know, the thing that brought it on wasn’t bringing it on any more. And the thing that wasn’t started to.
Everytime there was a “flare up” she’d look back, “what did I do that could have hurt my back?” Now its, “what did I eat that caused this?”
And the symptoms? With the back, it was pain or tightness or fatigue, and it was shoulder, middle, lower back, neck. With the IBS, sometimes it’s diarrhea, sometimes it’s constipation, sometimes it’s gas, sometimes it’s pain, sometimes nausea.
I’m not saying that all this will go away if doctors could tell patients, “get your head on straight.” There’s certainly real pain there. I guess I just think that there are complicated reasons going into it.
You sure you don’t have IBD? (Inflammatory bowel disease).
IBS doesn’t perforate.
Well, I don’t remember the doctors in the hospital, nor the gastroenterologist who treated me afterwards, ever using the term “IBD.” It was always “IBS.” But that might be my faulty memory.
I have what I think is mild IBS (the diarrhea-only type), although it hasn’t been formally diagnosed. It only troubles me in the mornings, usually. I haven’t really noticed it being related to stress much. I have noticed a few other things that suggest physical rather than psychological factors:
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It gets worse the week before my period.
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It is definitely affected by diet–worse with alcohol, coffee, and junk food, better with fiber, especially vegetables like cabbage and broccoli.
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It improves when I take acidophilous and fish oil supplements. It improved dramatically once when I was given antibiotics for an unrelated problem.
Trunk, differences in what has been said here are partly due to the loose layman’s language being used and partly changes in emphasis.
I agree with Dr._Paprika that IBS can be “aggravated by stress.” Symptoms may very well worsen in stressful times and be relieved by stress-reduction techniques. My argument is that stress is not causal.
As for what doctors say: I’ve been actively involved as a layman in researching and talking about digestive problems for over a quarter of a century. Most of what we now appear to understand about IBS has come to light only in the past few years. You’ll notice, for example, that most of the people in this thread who have it are men. But two decades ago, being female was almost a diagnostic for IBS. Men seldom were labeled that way. It was not until recently that any good research was even done on men. The studies had all women, because they were the ones who got IBS. The new medications are only for IBS are for women because the studies did not have men in them.
Bluntly put, most doctors - and way too many gastroenterologists - just have not been keeping up on this new research. I’m fortunate to have one who does. Try talking to him about it being psychosomatic - or about his colleagues. (And, yes, I’m using psychosomatic in the popular sense, not the technical one.)
Stress does not cause IBS. It is a functional disorder. The Rome II Guidelines for Diagnosis are purely functional. Stress is not mentioned, even as a contributing factor.
Within the next few years there will likely be tests for IBS that will be able to separate it off from the still idiopathic disorders that are confused with it today. Perhaps some of those are caused by stress. By definition, nobody knows. (idiopathic - “Of, relating to, or designating a disease having no known cause.”) I think it likely that IBS may get redefined as five different things, each with its own test and cure.
Quackery is a strong term, and perhaps I’m just reacting to the 50 nutcase books on the subject, some of them by doctors, as my absolute favorite is:
The Bible Cure for Irritable Bowel Syndrome
But if doctors still go into a diagnosis of IBS thinking that it’s all stress and not functional, they’re being quacks, and doing damage.
I’m not sure we want to take this side trip, but as for stress being a trigger - is there such a thing as stress that doesn’t result in some “symptom”? Wasn’t it Selye who proposed that stress is a self-perceived phenomenon? If it doesn’t bother you in any way, if it doesn’t cause any changes physiologically or in your behavior or your mental state, then it isn’t stress. And, conversely, those who suggest that stress is a trigger for their IBS are making that connection themselves. I also believe that it’s possible that certain unrecognized aspects of your life could result in bodily or behavioral changes and that it’s possible to actually discover those aspects. Those would be unrecognized stress factors, I suppose, but only if eliminating them (no pun intended) causes changes in the person. So, stress is called a trigger for some people but not for others. Whoo, I’ve not done this very articulately, but I think I know what I’m thinking. xo C.