IBS, Irritable Bowel Syndrome: Difference between revisions

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=== Entity / Miasms ===
 
* IBS is a disease which contain two main entities Anxiety + Illeeus and two optional entities Constipation or Diarrhae
* Autonomic nervous system disturbance is the key factor in its pathology.
* If Sympathetic nervous system is over activated, the patient has Diarrhea and in parasympathetic hyperactivity, the patient is constipated.
* Four Subtypes
** Diarrhea (IBS-D)
** Constipation (IBS-C)
** Mixed IBS (IBS-M)
** Unspecified (IBS-U)
{| class="wikitable"
|+
![[Entities list|Entities]]
!PLV
!RBS
!VZV
!EBV
|-
|Anxiety
| +++
| +++
| +++
| +++
|-
|Illeus
| +++
| +++
| +++
| +++
|-
|Constipation
|
|
|
| +++
|-
|Diarrhea
|
| +++
| +++
| +++
|-
| colspan="5" |'''Subtypes'''
|-
|IBS-D
|
| +++
| +++
| +++
|-
|IBS-C
|
|
|
| +++
|-
|IBS- mixed
|
|
|
| +++
|}
 
=== IBS, A genuine motility disorder ===
* I prefer to start IBS with wonderful abstract of Greger Lindberg: "New diagnostic techniques have advanced our knowledge about the IBS. The majority of patients that we believed to have a psychosomatic disorder have received other diagnoses explaining their symptoms. Endoscopy makes it possible to diagnose [[celiac disease]] before it leads to malnutrition and allows the detection of microscopic colitis as a cause of watery diarrhea. At the severe end of the symptom spectrum enteric dysmotility marks the border at which IBS ceases to be a functional disorder and becomes a genuine motility disorder. <ref>Karolinska Institutet, Department of Medicine, Huddinge and Karolinska University Hospital Huddinge, Patient Area Gastroenterology, Dermatology, and Rheumatology, SE-14186, Stockholm, Sweden. Electronic address: greger.lindberg@ki.se.</ref>
 
* Joint hypermobility or Ehlers-Danlos syndrome is present in a substantial proportion of patients with enteric dysmotility.
* [[CIPO, Chronic idiopathic intestinal pseudo obstruction entities|CIPO]] (Chronic intestinal pseudo-obstruction) is the end-stage of a large number of very rare disorders in which failed peristalsis is the common denominator.
* Nutritional needs and symptom control are essential in the management of pseudo-obstruction.
* Home parenteral nutrition is life saving in more than half of patients with chronic intestinal pseudo-obstruction." <ref>Lindberg G. Pseudo-obstruction, enteric dysmotility and irritable bowel syndrome. Best Pract Res Clin Gastroenterol. 2019 Jun-Aug;40-41:101635. doi: 10.1016/j.bpg.2019.101635. Epub 2019 Jul 22. PMID: 31594655.</ref>
 
* Intestinal motility disorder caused by Sympathetic/ Parasympathetic disorder. The role of interstitial Cajal cells in intestinal peristaltic movement in diseases such as [[Achalasia]], [[GERD, Gastroesophageal Reflux Disease|GERD]], [[CIPO, Chronic idiopathic intestinal pseudo obstruction entities|CIPO]] and post-infection IBS (PI IBS) has been almost proven.
* The mechanism of IBS disease is the imbalance of the intestinal autonomic system.
 
=== Gut dysbiosis ===
 
* Disruption of microbiota: Disturbance of the balance of normal intestinal flora microbes causes [[Leaky Gut Syndrome]], which means that the intestine becomes permeable to foreign antigens and as a result the occurrence of autoimmune diseases.
* This issue is so important that some believe in the triangle of genetics, environment and [[Gut Dysbiosis miams|Gut Dysbiosis]] in the formation of their diseases. <ref>Autoimmunity and the Gut Andrew W. Campbell<sup>*</sup> Autoimmune Dis. 2014; 2014: 152428.</ref>
 
=== [[Enteric nervous system]] ===
Two nerve networks are responsible for the movement and secretion of enzymes related to food digestion in the intestine:
 
# Extrinsic Nervous system = Sympathic / ParaSympathic
# Enteric nervous system= ENS
 
* Studies have confirmed the key role of ENS in IBS.
* Extrinsic disorders are divided into two types, [[LMN, Lower motor neuron entities|LMN]] and [[UMNS, Upper Motor Neuron Syndrome entities|UMN]], and occur in diseases such as [[MS, Multiple Sclerosis|MS]] and [[Parkinson disease|PD]].
 
* ENS itself has different parts in which serotonin plays the most important role . Therefore the critical role of serotonin in IBS is not accidental.
 
* Various pathologies can also involve ENS, for example, types of [[colitis]] such as Microscopic Colitis, which are divided into two types, (1) Lymphocytic and (2) Collagenic, and are related to IBD and IBS-D diseases, and [[MTB, Mycobacterium tuberculosis|MTB]] also plays a role in them.
 
* But only two diseases specifically involve ENS
*# [[Hirschsprung disease entities|Hirschsprung]]
*# [[Ogilvie syndrome miasms|Ogilvie syndrome]]
 
=== Sign / Symptoms ===
 
* Changes in the pattern of defecation
* Abdominal Pain / Discomfort
* Chronic symptoms with Recurrent attacks
* Urgency for stool or Tenesmus (incomplete evacuation) or bloating.
* Symptoms are relieved by defecation.
* These symptoms are due to changing in the continuity and frequency of bowel movements.
 
=== Related disease ===
 
* [[GERD, Gastroesophageal Reflux Disease|GERD]]
* [[Interstitial cystitis]]/ Bladder pain syndrome <ref>Chang KM, Lee MH, Lin HH, Wu SL, Wu HC. Does irritable bowel syndrome increase the risk of interstitial cystitis/bladder pain syndrome? A cohort study of long term follow-up. Int Urogynecol J. 2021 May;32(5):1307-1312. doi: 10.1007/s00192-021-04711-3. Epub 2021 Feb 23. PMID: 33620539.</ref>
* [[Fibromyalgia]] <ref>The Association of Irritable Bowel Syndrome and Fibromyalgia Lin Chang, MD Associate Professor of Medicine, Co-Director of the UCLA/CURE Neuroenteric Disease Program, Director of the UCLA Motility Unit</ref>
* Headache, backache, and psychiatric symptoms such as [[Major depressive disorder|depression]] and anxiety.
* Sexual dysfunction, typically reduction in libido. (33%)
 
 
=== [[3IFMC COE|3IFMC]] [[Cluster Of Entities]] ===
 
* Here we have one of most famous COD, named 3IFMC which includes IBS, [[CFS, Chronic Fatigue syndrome|CFS]], [[Fibromyalgia]] , Impotence, [[Interstitial cystitis]] and MDD
* As I mentioned in MDD chapter, its main miasms are EBV, CMV, PLV, HSV-1 and HSV-2.
 
{| class="wikitable"
|+
! colspan="2" |
=== [[Banerji protocols]] ===
|-
|'''First line'''
|
* [[Tub,Tuberculinum|Tub]] C200, one dose daily
* [[Nux-v , Nux Vomica|Nux-v]] C30 two doses daily
|-
|'''Second line'''
|
* [[Ign, Ignatia Amara|Ign]] C200, one dose daily
* [[Chel, Chelidonium|Chel]] C30 + [[Merc-v, Mercurius vivus|Merc-v]] two dose daily
|-
|'''Third line'''
|
* [[Aloe, Aloe socotrina|Aloe]] C200 one dose daily esp in indigested stool
|}
 
=== Documented Remedies ===
 
* [[Asaf, Asafoetida|Asaf]], [[Lyc , Lycopodium clavatum|Lyc]], [[Nat-m, Natrium muriaticum|Nat-m]], [[Ars, Arsenicum Album|Ars]], [[Nux-v , Nux Vomica|Nux-v]]
** One of the studies in the 2019 review also used Asaf as a homeopathic treatment.  <ref>International Journal of Science and Research (IJSR) ISSN: 2319-7064 SJIF (2019): 7.583</ref>
** A 2019 meta-analysis Trusted Source found that asaf was effective in reducing global IBS symptoms. <ref>Hawrelak JA, Wohlmuth H, Pattinson M, Myers SP, Goldenberg JZ, Harnett J, Cooley K, Van De Venter C, Reid R, Whitten DL. Western herbal medicines in the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Complement Ther Med. 2020 Jan;48:102233. doi: 10.1016/j.ctim.2019.102233. Epub 2019 Nov 3. PMID: 31987249.</ref>
** Another homeopathic remedy that the 2021 study. <ref>Martínez-Islas BR, Medel-Flores O, Pérez Soto E, García-Vivas JM, Hernández-Ruíz G, Sánchez-Monroy V. Evaluation of Individualized Homeopathic Treatment in Patients With Irritable Bowel Syndrome: A Pilot Study. Altern Ther Health Med. 2021 Jun;27(S1):158-161. PMID: 33711816.</ref>
 
== Remedies ==
{| class="wikitable"
|+
! colspan="2" |
!Modalites
|-
|
=== [[Lyc , Lycopodium clavatum|Lyc]] ===
|
* IBS with  food intolerances
* The inflamed digestive tract struggles to get enough nutrition from food, so there can be [[Emaciation|loss of weight]] + Abdomen Fullness / Bloating
* Appetite is very changeable and can go from being ravenous to very full after a few mouthfuls.
 
|
* Onions, Oysters, Cabbage and beans.
* Pains agg in the evening, typically from 4- 8 pm
* Pain amel by passing wind.
|-
|
=== [[Coloc, Colocynthis|Coloc]] ===
|
* Terrible stomach cramps 
* Pains are Short / Sharp / Pinching and
* Pains extend to Lower back / Buttocks
|
* Amel with doubling up
* Agg from anger or indignation.
* Agg after eating esp fruits
* Heat & pressure amel pain
|-
|
=== [[Nux-v , Nux Vomica|Nux-v]] ===
|
* Their stressful lifestyle disturbs their digestive system
* Severe [[Abdominal colic|stomach cramps]] and [[GERD, Gastroesophageal Reflux Disease|acid reflux]]
* [[Hiccups]], belching, fullness and [[Dyspepsia|indigestion]]
* There can also be a lot of nausea and feelings of being sea-sick.
|
* Agg after coffee, spicy foods
* Agg  with smoking.
* agg by mental exertion.
|-
|
=== [[Ars, Arsenicum Album|Ars]] ===
|
* [[Abdominal colic|Stomach cramps]] that agg after [[Common cold|taking cold]].
* They always feel chilly, Agg with cold food such as ice cream
* [[Diarrhea]] after Alcohol  whilst moving around makes everything worse.
 
|
* Amel with taking regular sips of a warm drink
* Amel with lying down to rest 
|-
|
=== [[Arg-n, Argentum Nitricum|Arg-n]] ===
|
* A lot of wind, with very loud and forceful belching or [[Flatulent remedies|flatulence]].
* Nausea and [[Dyspepsia|indigestion]] in Nervous / Anxious, esp when
|
* Agg in [[Anticipation anxiety remedies|anticipating]] a stressful event.
|-
|
=== [[Sul , Sulphur|Sul]] ===
|
* Stomach cramps agg by touch
* Burning pains agg  in Morning / Night
* Increased Appetite esp around 11am + All-gone sensation.
* Heavy Stomach  immediately after eating.
|
|-
|
=== [[Bry, Bryonia Alba|Bry]] ===
|
* Thirsty
* Stomach may feel so heavy, like a stone
* Belching amel the pain and tastes of undigested food.
|
* Agg after eating bread 
* Agg after Tight clothing
* Agg after walking about
|-
|
=== [[Carb-v, Carbo vegetabilis|Carb-v]] ===
|
* [[Old age|Older people]] or those suffering from general [[fatigue]] with stomach pains
* Stomach burning, sore or pressing.
* Stomach cramps / Being contracted with
* [[Dyspepsia]] + Weakness or [[Syncope|Faintness]].
|
* A lot of bloating after eating ([[Flatulent remedies|Flatulence)]]
* Butter/ Fats/ Rich foods cause belching, heartburn and indigestion
|-
|
=== [[Chin, China Officinalis|Chin]] ===
|
* Stomach acidity with a great deal of bloating & bitter or sour belching.
* The appetite swings from being ravenous to being completely off food + Feeling of fullness after eating a small amount.
* Slow Digestion
* Pains are pressing or sore.
|
* Fruit and milk agg and the
|-
|
=== [[Nat-m, Natrium muriaticum|Nat-m]] ===
|
* Indigestion after too much starchy food with sour belching & terrible hiccough.
* Painful stomach cramps, agg by touch.
|
* Strong emotions such as [[grief]] or stewing on the past can agg
|}

Latest revision as of 05:05, 1 December 2023

Entity / Miasms

  • IBS is a disease which contain two main entities Anxiety + Illeeus and two optional entities Constipation or Diarrhae
  • Autonomic nervous system disturbance is the key factor in its pathology.
  • If Sympathetic nervous system is over activated, the patient has Diarrhea and in parasympathetic hyperactivity, the patient is constipated.
  • Four Subtypes
    • Diarrhea (IBS-D)
    • Constipation (IBS-C)
    • Mixed IBS (IBS-M)
    • Unspecified (IBS-U)
Entities PLV RBS VZV EBV
Anxiety +++ +++ +++ +++
Illeus +++ +++ +++ +++
Constipation +++
Diarrhea +++ +++ +++
Subtypes
IBS-D +++ +++ +++
IBS-C +++
IBS- mixed +++

IBS, A genuine motility disorder

  • I prefer to start IBS with wonderful abstract of Greger Lindberg: "New diagnostic techniques have advanced our knowledge about the IBS. The majority of patients that we believed to have a psychosomatic disorder have received other diagnoses explaining their symptoms. Endoscopy makes it possible to diagnose celiac disease before it leads to malnutrition and allows the detection of microscopic colitis as a cause of watery diarrhea. At the severe end of the symptom spectrum enteric dysmotility marks the border at which IBS ceases to be a functional disorder and becomes a genuine motility disorder. [1]
  • Joint hypermobility or Ehlers-Danlos syndrome is present in a substantial proportion of patients with enteric dysmotility.
  • CIPO (Chronic intestinal pseudo-obstruction) is the end-stage of a large number of very rare disorders in which failed peristalsis is the common denominator.
  • Nutritional needs and symptom control are essential in the management of pseudo-obstruction.
  • Home parenteral nutrition is life saving in more than half of patients with chronic intestinal pseudo-obstruction." [2]
  • Intestinal motility disorder caused by Sympathetic/ Parasympathetic disorder. The role of interstitial Cajal cells in intestinal peristaltic movement in diseases such as Achalasia, GERD, CIPO and post-infection IBS (PI IBS) has been almost proven.
  • The mechanism of IBS disease is the imbalance of the intestinal autonomic system.

Gut dysbiosis

  • Disruption of microbiota: Disturbance of the balance of normal intestinal flora microbes causes Leaky Gut Syndrome, which means that the intestine becomes permeable to foreign antigens and as a result the occurrence of autoimmune diseases.
  • This issue is so important that some believe in the triangle of genetics, environment and Gut Dysbiosis in the formation of their diseases. [3]

Enteric nervous system

Two nerve networks are responsible for the movement and secretion of enzymes related to food digestion in the intestine:

  1. Extrinsic Nervous system = Sympathic / ParaSympathic
  2. Enteric nervous system= ENS
  • Studies have confirmed the key role of ENS in IBS.
  • Extrinsic disorders are divided into two types, LMN and UMN, and occur in diseases such as MS and PD.
  • ENS itself has different parts in which serotonin plays the most important role . Therefore the critical role of serotonin in IBS is not accidental.
  • Various pathologies can also involve ENS, for example, types of colitis such as Microscopic Colitis, which are divided into two types, (1) Lymphocytic and (2) Collagenic, and are related to IBD and IBS-D diseases, and MTB also plays a role in them.

Sign / Symptoms

  • Changes in the pattern of defecation
  • Abdominal Pain / Discomfort
  • Chronic symptoms with Recurrent attacks
  • Urgency for stool or Tenesmus (incomplete evacuation) or bloating.
  • Symptoms are relieved by defecation.
  • These symptoms are due to changing in the continuity and frequency of bowel movements.

Related disease


3IFMC Cluster Of Entities

  • Here we have one of most famous COD, named 3IFMC which includes IBS, CFS, Fibromyalgia , Impotence, Interstitial cystitis and MDD
  • As I mentioned in MDD chapter, its main miasms are EBV, CMV, PLV, HSV-1 and HSV-2.

Banerji protocols

First line
  • Tub C200, one dose daily
  • Nux-v C30 two doses daily
Second line
Third line
  • Aloe C200 one dose daily esp in indigested stool

Documented Remedies

  • Asaf, Lyc, Nat-m, Ars, Nux-v
    • One of the studies in the 2019 review also used Asaf as a homeopathic treatment. [6]
    • A 2019 meta-analysis Trusted Source found that asaf was effective in reducing global IBS symptoms. [7]
    • Another homeopathic remedy that the 2021 study. [8]

Remedies

Modalites

Lyc
  • IBS with food intolerances
  • The inflamed digestive tract struggles to get enough nutrition from food, so there can be loss of weight + Abdomen Fullness / Bloating
  • Appetite is very changeable and can go from being ravenous to very full after a few mouthfuls.
  • Onions, Oysters, Cabbage and beans.
  • Pains agg in the evening, typically from 4- 8 pm
  • Pain amel by passing wind.

Coloc
  • Terrible stomach cramps
  • Pains are Short / Sharp / Pinching and
  • Pains extend to Lower back / Buttocks
  • Amel with doubling up
  • Agg from anger or indignation.
  • Agg after eating esp fruits
  • Heat & pressure amel pain

Nux-v
  • Agg after coffee, spicy foods
  • Agg with smoking.
  • agg by mental exertion.

Ars
  • Stomach cramps that agg after taking cold.
  • They always feel chilly, Agg with cold food such as ice cream
  • Diarrhea after Alcohol whilst moving around makes everything worse.
  • Amel with taking regular sips of a warm drink
  • Amel with lying down to rest

Arg-n
  • A lot of wind, with very loud and forceful belching or flatulence.
  • Nausea and indigestion in Nervous / Anxious, esp when

Sul
  • Stomach cramps agg by touch
  • Burning pains agg in Morning / Night
  • Increased Appetite esp around 11am + All-gone sensation.
  • Heavy Stomach immediately after eating.

Bry
  • Thirsty
  • Stomach may feel so heavy, like a stone
  • Belching amel the pain and tastes of undigested food.
  • Agg after eating bread
  • Agg after Tight clothing
  • Agg after walking about

Carb-v
  • A lot of bloating after eating (Flatulence)
  • Butter/ Fats/ Rich foods cause belching, heartburn and indigestion

Chin
  • Stomach acidity with a great deal of bloating & bitter or sour belching.
  • The appetite swings from being ravenous to being completely off food + Feeling of fullness after eating a small amount.
  • Slow Digestion
  • Pains are pressing or sore.
  • Fruit and milk agg and the

Nat-m
  • Indigestion after too much starchy food with sour belching & terrible hiccough.
  • Painful stomach cramps, agg by touch.
  • Strong emotions such as grief or stewing on the past can agg
  1. ↑ Karolinska Institutet, Department of Medicine, Huddinge and Karolinska University Hospital Huddinge, Patient Area Gastroenterology, Dermatology, and Rheumatology, SE-14186, Stockholm, Sweden. Electronic address: greger.lindberg@ki.se.
  2. ↑ Lindberg G. Pseudo-obstruction, enteric dysmotility and irritable bowel syndrome. Best Pract Res Clin Gastroenterol. 2019 Jun-Aug;40-41:101635. doi: 10.1016/j.bpg.2019.101635. Epub 2019 Jul 22. PMID: 31594655.
  3. ↑ Autoimmunity and the Gut Andrew W. Campbell* Autoimmune Dis. 2014; 2014: 152428.
  4. ↑ Chang KM, Lee MH, Lin HH, Wu SL, Wu HC. Does irritable bowel syndrome increase the risk of interstitial cystitis/bladder pain syndrome? A cohort study of long term follow-up. Int Urogynecol J. 2021 May;32(5):1307-1312. doi: 10.1007/s00192-021-04711-3. Epub 2021 Feb 23. PMID: 33620539.
  5. ↑ The Association of Irritable Bowel Syndrome and Fibromyalgia Lin Chang, MD Associate Professor of Medicine, Co-Director of the UCLA/CURE Neuroenteric Disease Program, Director of the UCLA Motility Unit
  6. ↑ International Journal of Science and Research (IJSR) ISSN: 2319-7064 SJIF (2019): 7.583
  7. ↑ Hawrelak JA, Wohlmuth H, Pattinson M, Myers SP, Goldenberg JZ, Harnett J, Cooley K, Van De Venter C, Reid R, Whitten DL. Western herbal medicines in the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Complement Ther Med. 2020 Jan;48:102233. doi: 10.1016/j.ctim.2019.102233. Epub 2019 Nov 3. PMID: 31987249.
  8. ↑ Martínez-Islas BR, Medel-Flores O, Pérez Soto E, García-Vivas JM, Hernández-Ruíz G, Sánchez-Monroy V. Evaluation of Individualized Homeopathic Treatment in Patients With Irritable Bowel Syndrome: A Pilot Study. Altern Ther Health Med. 2021 Jun;27(S1):158-161. PMID: 33711816.
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