As promised, here is a recap from my trip down to Chapel Hill, North Carolina last Saturday for the UNC IBS Patient Symposium 2006.
Let me start with one overall observation: For somebody with IBS, attending this symposium is the equivalent of an average citizen sitting across from world leaders like George Bush, Tony Blair, Jaques Chirac, and Vladmir Putin at the G8 Summit and not only having the chance to listen in as they discuss the latest thinking on the world’s greatest problems, but also being able to raise your hand and have them answer any question you care to ask. Sponsored by the University of North Carolina Center for Functional GI and Motility Disorders and taught by its world-renowned faculty, this is truly a one-of-a-kind event because it’s the only IBS conference that’s specifically geared not toward doctors, but toward patients. In other words, even I could understand what they were talking about - well, most of the time, anyway.
First, the bad (and perhaps obvious) news: Even the world’s leading IBS experts still don’t know exactly what causes IBS or how to cure it. Complicating matters, because no two people suffer from IBS in exactly the same way, there is still no single treatment method that will work for everybody.
Now, having said that, I came away from the conference feeling very optimistic about the progress being made with IBS research and treatment options. Please note that many of the symposium’s presentations went into quite a bit of technical/medical detail, and I have done my layman’s best to accurately paraphrase the highlights of what is by nature a complex subject matter. I apologize in advance for any innacuracies or mischaracterizations.
Dr. Doug Drossman kicked off the day with the most welcome assurance that even though IBS is a functional disorder (meaning that the diagnosis is based on the presence of specific symptoms rather than the presence of an organic disease that might show up in colonoscopies, blood tests, etc), the condition is indisputably very real. While the exact mechanism is still not completely understood, he went on to explain that a great deal of the recent IBS research has focused on the two-way interaction between the brain and the gut. While people with IBS often have a lower threshold for pain in their digestive tracts (aka “visceral hypersensitivity”), evidence shows that these pain signals from the gut are often exaggerated or amplified by the time they reach the brain. To make matters worse, when the brain receives these amplified pain signals, it reacts with its own stress response by releasing something called CRH, a hormone associated with stress and anxiety that causes the bowels to go into instantaneous overdrive, more so in people with IBS. Not surprisingly, the hottest area in IBS research is the effort to develop a CRH antagonist, a drug that will block the release of this hormone responsible for the body’s overreaction to stress. Unfortunately, it looks as though it will be another two or three years before any of these treatments come to market.
After learning that the brain-gut connection is a key component in IBS and that the disorder is neither purely physiological nor completely psychological, Dr. William Whitehead addressed some of the common risk factors associated with IBS. Many of us with IBS have heard people - sometimes even doctors - tell us that IBS is caused by stress, or by anxiety, or by eating the wrong types of foods, or, in some cases, by an overgrowth of bacteria in the small intestine. According to Dr. Whitehead, while these are certainly risk factors that are assoiciated with, and can exacerbate or trigger, IBS symptoms, there is no conclusive evidence that they cause IBS. Furthermore, he said that researchers are increasingly coming to the conclusion that IBS is not even one single disease, but rather many different diseases.
Building on the discussion about the role of the brain-gut connection, Dr. Charles Burnett explained how cognitive-behavioral therapy teaches IBS patients to improve their symptoms by literally changing the way they consciously think about their symptoms (to learn more about cognitive-behavioral therapy, or to find a therapist near you, visit www.academyofct.org). Presenting a compelling case for treating IBS with hypnotherapy, Dr. Olafur Palsson described how this alternative treatment method, which uses safe and relaxing subconscious suggestions to improve the interaction between the brain and the gut, has consistently produced a response rate that exceeds 80% in studies published to date (to locate a practitioner who is licensed to treat IBS patients using Dr. Palsson’s standardized word-by-word IBS Treatment Protocol, please visit www.ibshypnosis.com).
Following a full morning of digesting the latest and greatest IBS knowledge, it was time to digest some much-needed lunch. While people at the other tables got to sit down for an informal Q&A session with the symposium’s speakers and other members of the UNC Center’s faculty, I enjoyed the chance to sit down and talk with Jeff Roberts. For those of you who might not recognize the name, Jeff is the pioneer who founded the IBS Self-Help Group and single handedly created an online community where millions of isolated IBS sufferers from around the world can connect with each other to compare notes, share resources, and support one another. He’s an incredibly nice guy, and it was a real honor to sit down and chat with someone who has done so much to raise public awareness for IBS.
After lunch, the all-star lineup of speakers continued. Taking a break from the scientific and medical jargon that characterized the morning sessions, Nancy Norton, President and Founder of the International Foundation for Functional Gastrointestinal Disorders, addressed a far more human topic, one that could only be covered by somebody who has personally lived with IBS. Nancy’s keynote, as the title “How to Talk with Your Doctor” suggests, focused on how uncomfortable so many people are when it comes to discussing their bowel habits or bowel irregularities with their physicians. It’s worth noting that many doctors are also reluctant to breach this awkward ground. The tragedy of this “failure to communicate” (to steal a phrase from the movie Cool Hand Luke) is that because the doctor comes away from the appointment having no idea what the patient is really experiencing, the patient leaves the office without a proper diagnosis and, in all likelihood, without an effective treatment plan to improve his symptoms. In addition to urging patients to be their own advocates when talking with their doctor, Nancy offered two great pieces of tangible advice: First, it’s important for patients to explain not only their symptoms, but also to explain specifically how their symptoms impact their day-to-day life; Second, to ensure that your doctor is fully engaged in the dialogue at hand, ask, “What else can I tell you that will help you understand me better?”
OK, that’s a wrap. As always, I’d love to hear from you, so please feel free to post a comment or, if you like, go to the “contact me” link on my homepage and email me directly.
Tim
