Diet-and-IBS，-Fibromyalgia，-and-Migraine.ppt

Diet and IBS, Fibromyalgia, and Migraine What Is Irritable Bowel Syndrome? Symptom Based Diagnosis of Exclusion Diarrhea Predominant IBS Constipation Predominant IBS Cyclic IBS Rome II Criteria for IBS Relief after defecation Onset associated with a change in stool consistency Onset associated with a change in stool frequency Rome II Continued ??Other symptoms that are not essential butsupport the diagnosis of IBS: ? Abnormal stool frequency greater than 3 bowel movements/day less than 3 bowel movements/week Abnormal stool form lumpy/hard loose/watery stool Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation) Passage of mucus Bloating or feeling of abdominal distension. Source: International Foundation of Functional Gastrointestinal Disorders When You Should Ask The Doctor to Double-Check  IBS Diagnosis: Profound weight loss, anemia or blood/occult in stool Travel to places with parasitic endemics Hx of colon cancer Skin abnormalities Signs of malabsorption Thyroid dysfunction This list is not exhaustive, but is helpful… Consequences of IBS Patients with IBS averaged 15 of 30 days with poor physical or mental health. These average overall unhealthy days exceeded those of respondents with arthritis, diabetes, heart disease/stroke, cancer, and class III obesity (body mass index or =40 kg/m2) from the U.S. survey. Traditional Therapies Medication Side Effects Band-Aid solution- only addresses symptom of diarrhea, not underlying problems so other problems continue. IBS is not a distinct entity buta collection of disorders “Food intolerance represents an important proportion of conditions which together make up IBS” IBS not only symptom Lancet 2000 Jul 29;356(9227):400-1 “We found that food provocation in food intolerant patients was characterized by a general and systemic immune activation accompanied by an increase in systemic symptoms… important for the understanding of the mechanisms involved in the pathogenesis o