Irritable Bowel Syndrome IBS and What Tests You Should Get
Kenneth Falchukgt;gt;gt; Irritable bowel syndromeis the word points to it, is a syndrome, it is a composite of complaints that patientshave that effect the GI tract. It is not something that we could immediately say is caused byan infection or is caused by a structural change in the bowel. So therefore the physician who evaluates thepatient with irritable bowel syndrome (IBS) has to pay attention to the types of symptoms,when they occuré How frequent is your trigger factor, has to evaluate his patient for thepossibility of other conditions and that is where we bring in the criteria of or the charactersof what we call reg flags.
So irritable bowel syndrome is a combinationof symptoms that the patient mentions to the treating evaluating physician that consistsof either pain with or without a change in bowel habit such as diarrhea, constipation,or a variable pattern, a mixture of both diarrhea or constipation with bloating with a changein a shape, consistency of they stools, they could be loose, they could be hard, they couldbe like little fragments. Above all, the irritable bowel does not havethe red flags that I mentioned previously, that is the presence of bleeding, very significantrelevant weight loss in a short period of time, no fever, and no vomiting, once we considerthe red flags and if they are not present
in the patient, there are other lab resultsthat we could request to evaluate the patient and exclude something that may be caused byanother illness other than the IBS, the irritable bowel. If a physician requests those labs, they arenot specific. There is no specific blood test to make the diagnosis of an irritable bowel.So what one does when he looks at the lab for help to see if there is anemia, evidenceof bleeding indirectly or directly, a low red cell count, a low iron or something calledferritin, signs of inflammation in the blood. We request a test called Sed rate or CRP thatindirectly look at this aspect.
Other tests may show low protein to suggesta difficult absorption, nutrition, which is not really a main issue when one deals withirritable bowel. So once the red flags are excluded and that the physician is certainabout that, he or she can then say â€œWell I am not yet sure. I need to evaluate my patientproperly.â€� That can be done with xrays such as CAT scan, xray of a small intestine,a barium enema sometimes or proceed to something more specific and definitive, yet somewhatinvasive called a colonoscopy where you look at the lining of the colon. You can take samplesand make sure there is no inflammation. The bottomline is to make sure that thereis no colitis because colitis is treated differently.
It is somewhat of a greater concern to somepatients because it could bleed to serious consequences and disabilities, so it is importantnot to attach diagnosis of IBS, irritable bowel, to someone who may have something thatcan be treated differently and therefore modify their quality of life and outcome. I think that more or less summarizes whatI have been trying to convey about what IBS irritable bowel syndrome is and how to proceedwith a detail specific evaluation of this condition.
Winning Strategies for Back Pain Disability Cases
Hi there, this is Jonathan Ginsberg and today I'd like to talk to you about how I approach a case where the primaryimpairment is back pain As you might expect SocialSecurity judges see a lot of back pain cases its probably the mostcommon physical ailment that Social Security judges are going to see and as such you really need to keep in mind that you've got to stand out a little bit because
a lot of people come in withosteoarthritis and pain in their lower back and again because judges see it sooften how they tend to sometimes discount the severity of it and whether in fact it is truly disabling. Further you have to realize and this issomething you probably wouldn't think about, but it's actually the case
some of the judges that I've beenin front of have actually had back surgery because again back problems are prettycommon in the population and of course a lot of these judges have very goodinsurance they have physical therapy afterwards, they have good s and soforth and so their recovery might be more uneventful than yours. Again, a judge is not doing physical labor
and again he has got typically real goodhealth care. If you've done physical labor or if your health care is not as good youdon't have access to physical therapy or or medication or as much follow up then you may not have gotten the same resultsas the judge but again the judge who's deciding your case is looking at yousaying quot;I went through the same surgery and I'm fine. You know I can't play basketball anymore but but I can play golf and I can do a lot of different thingsquot; and
he or she you may feel likewell you know I've recovered how why can't youé And, again, that's just human nature but just beaware of it. I'm not saying that makes the judge not sympathetic to you butjust be aware that you need to do something to stand out a little bit andshow the judge that your situation is one that did not resolve as easily as his or hers may have. I think that when you deal withback pain cases like in any Social Security case
number one you want to emphasize ifyou've got a long work history. I think this is a factor that you may not think about but this is i think a factor that many judges find it very verycompelling. If you have a long consistent workhistory where you've been in a job, you've performed admirably at the job you've madegood money at the job. people don't give up good jobs and opportunity for retirement, a pleasant retirement, to collect $1,500 or
Candida Case Study 11 Jean WIth Serious Irritable Bowel Syndrome
This is another case history and this is quitea mindblowing case history. This is a 63yearold lady called Jean who I've seen. Jean is oneof these medical disasters. This is the Titanic of the lady's with irritable bowel syndrome.This was a disaster in the making and a disaster waiting to happen, and it's a terrible tragiccase. It should've been completely avoided. This woman is just another absolute, completebotch up of the medical profession. I'm not bagging all s because I've gota lot of medical s and specialist friends whom are fantastic people doing amazing jobs,but there are plenty of medical s out there that do terrible jobs. You always seegood and bad in all professions. I've seen
terrible naturopaths and good naturopaths.I've seen terrible chiropractors, so these case histories are not meant to be baggingsessions for medical practitioners. But this case here is one where everything went wrongfor this poor woman, and it basically ruined her life until we started to really set thingsright. I'm going to read a bit out of my book, as I usually do with some of these cases,and I'll do a narration along the way. Jean saw me a while ago now and came fromEngland to settle down in New Zealand. When this patient first came in, what struck mewas how thick her file of notes from London was. It was literally three inchesthick of notes. This patient had been suffering
with multiple digestive complaints for over40 years, including cramping, bloating, nausea, and continual diarrhea up to 10 bowel motionsper day. Her main problem was her increasing intolerance to foods, and Jean's diet hadbecome so incredibly restrictive that she could only eat a few foods, including chicken,fish, spinach and fresh green beans, and that was it. Most foods would set off terriblestomach pains she was experiencing, which caused her to eat less and less.Jean was one of those patients who ticked every condition box on my case taking form.She had headaches, insomnia, migraines, arthritis, anxiety, depression, urinary tract infections,and, in fact, Jean had everything. This patient
had been to over 25 s, several specialists,a bowel specialist, including herbalists, naturopaths, physiotherapists, osteopaths,and even more. The main concern was Jean's weight. It had dropped to less than 80 pounds,' kilos. And at 5 foot 6 inches in height, it's pretty bad. A woman that tall literallylooks like something that had come out of one of these concentration camps with herliberation. It was quite terrible to see a patient like that in my room because you couldsee the bones everywhere. And of course, what her bowel specialist in England said, he toldher that she needed to put on more weight, so he told her to eat more potato chips andmore chocolate to gain weight, which is why
he's a bowel specialist. More like an idiotas far as I'm concerned to tell someone with a bowel problem to eat lots of chocolate andcrisps. It's a stupid thing to do, isn't ité What tests were performed on Jeané Apart fromthe usual blood tests, this poor woman had over a dozen colonoscopies performed and eachtime all was normal. The last visit this patient had to the gastroenterologist, quot;Our findingsindicated that Mrs. X has no significant disease.quot; No other tests were ever performed. No stooltests. No allergy test, just bowel examinations and the odd endoscopy, so that's a cameradown the throat. A camera up the backside, a camera down the throat, they couldn't findanything.
What I do with cases like Jean. Whenever Isee these patients, I usually do a comprehensive digestive stool analysis times three. It'sthe best stool test you can do. And guess what we foundé We found multiple issues ascan be expected. But in this particular case, we found a level three of Candida in all stoolsamples. This woman had three plus, which is a lot of yeast that could be cultured ineach stool sample. This is one of the worst bowel cases I've ever seen involving a yeastinfection. That was a significant finding for the patient, and the first time we hadanswers. The patient and her husband were absolutely delighted, but also equally annoyedthat it took 40 years to find the answers.