In a study of extra-intestinal symptoms in IBS patients we found that thigh pain, muscle and joint pain, and back pain are more frequent in IBS-C than IBS-D and IBS-M. What could be the underlying mechanism for such association?
J Gastroenterol Hepatol. 2014 Aug 5. doi: 10.1111/jgh.12704. [Epub ahead of print]
Irritable bowel syndrome: a comparison of subtypes.
Rey de Castro NG, Miller V, Carruthers HR, Whorwell PJ.
I cite these researchers' paper's abstract:
Irritable bowel syndrome (IBS) is traditionally divided into subtypes depending on the bowel habit abnormality but there is little clarity in the literature about whether these subtypes differ symptomatically or psychologically. Furthermore, there are conflicting reports on the relationship between symptom severity and psychological status. The aim of this study was to address these issues in a large cohort of patients defined by bowel habit.
METHODS:
1000 IBS patients were divided into diarrhea (IBS-D), constipation (IBS-C) and mixed (IBS-M) bowel habit subtypes and completed a series of validated questionnaires capturing symptom severity, non-colonic symptomatology (somatization), quality of life and anxiety or depression levels. Comparisons were made using the statistical package for social sciences version 20.
RESULTS:
There were no significant differences between the three subtypes with respect to symptom severity, abdominal pain intensity, non-colonic symptomatology, quality of life and anxiety or depression scores (all ps>0.05). In addition, there was only a small but statistically significant correlation between IBS symptom severity and both anxiety or depression as well as quality of life (highest r=0.34) while the relationship between somatization and disease severity was moderate (r=0.42).
CONCLUSION:
This study suggests that there are no differences in the symptom profiles and anxiety or depression scores between different subtypes of IBS. In addition, anxiety and depression do not appear to be strongly associated with symptom severity although this does not exclude the possible interplay between these and other psychological drivers of severity, such as poor coping skills."
quote ended.
We believe that IBS is really a form of food induced brain dysfunction that we call Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. It appears that the long term consumption of highly processed food containing excessive fructose, high glycemic carbohydrates especially from grains and excessive omega 6 fatty acids is bad for your brains. That includes the one between your ears and your second brain called the enteric nervous system (ENS).
When this brain goes south you end up with IBS symptoms. When this process affects your bladder you end up with interstitial cystitis.
Well I have a very simple answer. They sit for hours on persian toilet, As you know this is very difficult and may impose lots of physical stress on thigh and back.
Best.
Sitting in Toilet for long in IBS-C, especially considering our Toilets design !, seems to have a role. But, it may not be just that simple.
There is some evidence that IBS-C has lower parasympathetic tone than IBS-D. The lower parasympathetic tone which may contribute to constipation may also result in generalized pain as the parasympathetic activity is anti-nociceptive. This association may partially explain the finding.
There it is !
Jarrett et al. just recently published their study on visceral and somatic pain sensitivity and modulation in IBS patients according to different bowel subgroups and showed that IBS-CM patients have higher visceral as well as somatic pain sensitivity and less pain modulation efficiency than IBS-D patients.
http://www.ncbi.nlm.nih.gov/pubmed/26993039
Whether such differences are related to difference in vagal activity was not clear from this study, but it needs further evaluation as their method of ANS assessment and analyses is not optimal.
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