Invest in ME Conference 12: First Class in Every Way
OverTheHills wraps up our series of articles on this year's 12th Invest in ME International Conference (IIMEC12) in London with some reflections on her experience as a patient attending the conference for the first time.
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"No, irritable bowel syndrome is not all in your head" by James C Coyne

Discussion in 'Gastrointestinal and Urinary' started by Dolphin, May 22, 2016.

  1. Dolphin

    Dolphin Senior Member

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    May 21, 2016
    James C Coyne

    Brain-gut interactions, citizen scientist, clinical trials, Freud, human subjects, IBS, Informed consent, Irritable bowel syndrome, ME/CFS, Psychosomatic, psychotherapy, Uncategorized, women's health Cedar-Sinai, It's All in Your Head, Jonathan LaPook, Mark Pimentall, PRINCE trial, Simon Wessely, Suzanne O'Sullivan

    https://jcoynester.wordpress.com/2016/05/21/no-irritable-bowel-syndrome-is-not-all-in-your-head/

    Summary:

     
  2. Skippa

    Skippa Anti-BS

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    Ha! I went to a gastro who said "yep IBS" and then promptly shipped me off to the mental folks.

    That's how they got me hooked lifelong on SSRIs.

    Still got the IBS.
     
  3. panckage

    panckage Senior Member

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    So curious, I have IBS caused by food triggers. So far I know my IBS is caused by wheat, soy, brocolli, bok choi, all spices I have tested, cocoa, onions, green peppers, and I'm sure many others that I have yet to figure out. Eg. peanuts give me IBS too, but I've bought peanuts in the shell that say they may contain soy so I really have no idea if I actually have problems with peanuts or if its due to a soy impurity... I have many other problems like this with fish and other things. I pretty much need to have guaranteed pure food to figure out my intolerances at this point but I don't even think that label even exists :p

    Its very frustrating. Its no longer about avoiding problem foods for me. The only way I can avoid IBS to to only eat foods/brands I know are ok.

    My doctor said there is no point in referring me to anyone for this. Is there any specialist that might be able to help me with this? Like for example have knowledge of the contaminates in the food industry in order to better guide me?
     
    barbc56 likes this.
  4. erin

    erin Senior Member

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    ''Previous explanations for IBS focused on it being an expression of unconscious conflicts. Psychoanalytically oriented explanations suggest anal conflicts in which the patient struggles with hostility that she cannot express directly. IBS can been seen as a conflict between retaining in expelling fecal contents. Diarrhea or loose bowel movements can be seen as symbolically crapping on somebody in a situation where anger cannot be directly expressed.''

    Is this real? I can't believe this could ever be taken seriously. Blame everything to anxiety and/ depression. So SSRI industry benefits.
     
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  5. chipmunk1

    chipmunk1 Senior Member

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    [​IMG]
     
  6. barbc56

    barbc56 Senior Member

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    Yes!

    My PCP says the same thing, that IBS is neurological and she sees it a lot in her Fibromyalgia patients. The best thing
    Well, I would agree with the word conflict but without the adjectives. IBS can be IBS-D or IBS-C. That sounds like a conflict to me.:lol:

    My PCP believes IBS is neurological and also teaches medical students. Maybe there's hope?
     
    Luther Blissett likes this.
  7. Hip

    Hip Senior Member

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    I am very happy to see that Professor Coyne is addressing other conditions that have also had the misfortune of being considered "all in the mind" diseases. It's not just ME/CFS that was tarred with the somatoform brush, but also IBS, interstitial cystitis, fibromyalgia, and others.

    People with those diseases also deserve better from medical research. They should not be fobbed off with somatoform psychobabble.
     
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  8. kangaSue

    kangaSue Senior Member

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    It won't be until they start doing routine full thickness biopsies for IBS that there will be a clearer picture that it has an immune response cause due to low grade inflammation as a result of increases in enteric mucosal chronic inflammatory cells as have already been noted in studies where there has been apparently normal findings with just routine examination.
    http://www.nature.com/modpathol/journal/v19/n12/full/3800704a.html
    http://www.gastrojournal.org/article/S0016-5085(02)00469-9/fulltext
    http://onlinelibrary.wiley.com/doi/10.1111/nmo.12315/pdf
     
  9. mermaid

    mermaid Senior Member

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    Actually I think the NHS in the UK is a bit more enlightened these days on IBS. I was diagnosed some 40 years + ago, and was first given tranquillisers by one doctor, and then Codeine Phosphate by another, though I did have some internal checks as well to ensure it wasn't something being caused by anything they could detect physically.

    If you look at the NHS site now it first talks about changing the diet and a discussion on the FODMAP approach, although it does then mention that medication or a psychological approach may also be helpful.

    Whether individual gastros are as enlightened is another matter......though I do know that dieticians are now trained in FODMAPs.

    In my own case I have pretty well eliminated IBS via the dietary approach (not FODMAPs as such), but as I also now have upper gut issues (Functional dyspepsia) it has taken a bit longer to get on top of that also via further food restrictions/changes.
     
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  10. valentinelynx

    valentinelynx Senior Member

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    Tucson
    Classic Freudian psychoanalytic interpretation.
    In other words, unscientific nonsense from 100 years ago accepted as gospel without proof.
     
  11. valentinelynx

    valentinelynx Senior Member

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    When I was in medical school (1995), in the pre-clinical (lecture) years, I recall a presentation by some guy - I think he was either a gastroenterologist or a pathologist. He stated definitively that no physical abnormalities were present in IBS.

    I raised my hand and said, "Don't you mean that we have not yet found any physical abnormalities in IBS?" I found the assertion that because nothing had yet been found, that it did not exist, to be ridiculous.

    The lecturer, however, rebutted with, "No. There are no pathological findings." Period. End of story. My mind is closed.

    Strong lesson that day on the nature of modern medicine.

    (I wonder if that guy remembers that day when reading the current literature. Probably not - he either doesn't read the literature - after all, he knows everything already - or if he now believes there are real physical changes in IBS, then he knew it all along...)
     
  12. chipmunk1

    chipmunk1 Senior Member

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    Today he would say: There are pathological findings." Period. End of story
     
  13. erin

    erin Senior Member

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    The stigma attached to the mental illness allows the scientific community easily dismiss their own negligence and mishandling patients. It is so easy to blame a lot of illnesses, syndromes, symptoms and conditions on "mental illness". And do nothing about them apart from prescribing the antipsychotic medicine.

    I actually think the opposite. Since certain types of autoimmune encephalitis can be mistaken for schizophrenia or mental illness there must be a lot of patients ill with physical causes possibly diagnosed as mentally ill.

    And what do we do with the mentally ill in any society in this world?

    I am currently reading an amazing book; History of Madness by Michel Foucault. Translated from French, it is a heavy book, written for the academics and difficult read for me as English is not my native language. But still I am enjoying it.
     
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  14. Mark

    Mark Former CEO

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    When you've got through that, Madness and Civilisation is also really good. :D
     
  15. erin

    erin Senior Member

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    Oh, I had to read part of that which is actually the earlier version of the translation. It fried my brains! This one has a much clearer language.
     
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  16. Mark

    Mark Former CEO

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    It rather fried my brains (but in a good way :D) when I read it about 20 years ago...and that was reading it in my first language, before I got sick. So I'm glad to hear that History of Madness is easier to read! :)
     
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  17. msf

    msf Senior Member

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  18. u&iraok

    u&iraok Senior Member

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    Why are the words 'I don't know' or 'we just don't know' or 'we don't know at this time' so hard to say?

    Or better yet, 'science-based medicine doesn't know at this time, I recommend you see a nutrition-based doctor'
     
  19. kangaSue

    kangaSue Senior Member

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  20. anciendaze

    anciendaze Senior Member

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    Coyne concentrates on the microbiome, but this is not independent of changes in mucous membranes of the gut. Recognition of mast cell activation disorders is less than 10 years old, but when this causes IBS there are tests that provide clear pathological evidence. The wall of the intestine may look normal through an endoscope, but if you take random biopsies from tissues that look normal, and stain this to show CD117, CD25 and CD2 the active mast cells stand out. Healthy people generally have fewer than 20 mast cells in a standard field of view, but those with MCAS/MCAD can have 3, 4 or even 5 times as many. Such evidence is unusually strong.

    When we are better able to distinguish active mast cells with particular characteristics we will be able to diagnose IBS even if the number of mast cells per field of view is not above 20. The problem in the past was that we didn't even know how many mast cells were present. We still have trouble figuring out what they are doing. I'm waiting for some bozo to assert that crazy people can subconsciously control behavior of individual mast cells.

    Medical textbooks concentrate on release of histamine from mast cells in allergies or asthma, and on release of tryptase in the rare disease mastocytosis. Somehow, they manage to overlook the release of heparin, which is typically in complexes with tryptase and can be responsible for localized bleeding. These are only 3 chemical signals controlled by mast cells out of about 200. We still have a lot to learn.
     

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