Coeliac Disease is fpour times more common in those diagnosed with IBS.
Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis.
Ford AC, Chey WD, Talley NJ, Malhotra A, Spiegel BM, Moayyedi P.
MB MRCP, Gastroenterology Division,
Abstract
BACKGROUND: Individuals with irritable bowel syndrome (IBS) report abdominal pain, bloating, and diarrhea, symptoms similar to those in celiac disease. Studies suggest that the prevalence of celiac disease is increased in individuals with IBS; however, evidence is conflicting, and current guidelines do not always recommend screening for celiac disease in these individuals. METHODS: We conducted a systematic review and meta-analysis to estimate prevalence of celiac disease in unselected adults who met diagnostic criteria for IBS. MEDLINE (1950 to May 31, 2008) and EMBASE (1980 to May 31, 2008) were searched. Case series and case-control studies that used serologic tests for celiac disease were eligible for inclusion. Prevalence of positive serologic indications of celiac disease and biopsy-proved celiac disease were extracted and pooled for all studies and were compared between cases and controls using an odds ratio and 95% confidence interval. RESULTS: Fourteen studies were identified comprising 4204 individuals, of whom 2278 (54%) met diagnostic criteria for IBS. Pooled prevalence of positive IgA-class antigliadin antibodies, either positive endomysial antibodies or tissue transglutaminase, and biopsy-proved celiac disease were 4.0% (95% confidence interval, 1.7-7.2), 1.63% (0.7-3.0), and 4.1% (1.9-7.0), respectively. Pooled odds ratios (95% confidence intervals) for positive IgA-class antigliadin antibodies, either positive endomysial antibodies or tissue transglutaminase, and biopsy-proved celiac disease in cases meeting diagnostic criteria for IBS compared with controls without IBS were 3.40 (1.62-7.13), 2.94 (1.36-6.35), and 4.34 (1.78-10.6). CONCLUSION: Prevalence of biopsy-proved celiac disease in cases meeting diagnostic criteria for IBS was more than 4-fold that in controls without IBS.
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Continence experts demand clarity over Ryanair's toilet proposals
Some of the UKs leading Continence experts, surgeons, nurses and patient groups have expressed their concerns at Ryanair's proposals to reduce the number of toilets on board their aircrafts and to charge passengers to use them. Clarity is called for in light of the contradictory stories running in the press.To view to the whole story click here.
I know what its like and could be of help
Hello, my name is Mindi Kane; I am a qualified counsellor with over 13 years experience. Perhaps, more pertinently, I myself have suffered from IBS, coeliac disease, adhesions and a redundant colon. I know what it’s like to writhe in pain on the bathroom floor, to worry about getting to an appointment when I am having a bad day and not to make it to the loo. I have spent the last 30 years finding ways to manage my condition. I am keen to help others through the challenges of day to day living with gut problems and offer a comprehensive counselling service. I can do this in person, over the phone or even by Skype. I am a qualified Bach flower practitioner, qualified in Japanese acupressure massage, Indian head massage, hand reflexology massage, EFT (Emotional Freedom Therapy) and Reiki to level 3 (teacher) and I have studied basic nutrition. I can use all these in conjunction with counselling to help others through the challenges of gut problems or alternatively just straight forward counselling! My approach is person centered; entirely focussed on finding out what works for the individual.
Should you wish to contact me for a chat before arranging an appointment I am happy to do that. My phone numbers : 01749 850046. Mobile: 07980515337. email: mindi.kane@ukonline.co.uk
'But you dont look ill...'
Then you are not alone - join us for cheerful chat and support
Ryanair Confirms it WILL Bring in Charges for On-Board Toilets
Ryanair has confirmed that it is pushing ahead with its controversial scheme to charge passengers for use of toilets on its aircraft, meaning spending a penny on a flight will soon cost as much as a pound.Check the full article HERE
Let us know what you think by emailing us at info@theguttrust.org
Public toilet petition now on Number 10 Website
Members of the public with access to the internet can now view and sign a petition on the number10 web site at http://petitions.number10.gov.uk/publictoiletkeep/ to try to get local authorities to open more publc toilets, please spread the word. Thanks.
F.E.Sharpe.
Free massage for IBS in Bristol
'I am a Holistic Massage trainee currently studying with Bristol College of Massage and Bodywork. Till the end of April I am carrying a research how holistic massage can effect and benefit the people with IBS (Irritable Bowel Syndrome). Please get in touch so as to arrange free of charge massage session in Bristol Clifton area. Call on 07979403396 or e-mail. lina.serenaite@gmail.com . Lina'
Free Hypnotherapy in the West Midlands
I have set up a Primary Care pilot hypnotherapy service which follows the NICE guidelines for IBS. This is free to patients who have GPs in the Tipton and Rowley Regis and Sandwell regions in the West Midlands (helen.bremner1@nhs.net),.
Helen Bremner
Community Clinical Nurse Hypnotherapist (BCCN)
Sandwell Primary Care Trust
Suite 12, Vision Point Offices
07792 946 841
An apple a day ......
Hi,I just wanted to put the word out there.I have had IBS for 10 years now,but I believe I have found a way to control it.
The most effective treatment I have found is simply 1 green apple a day. It stops stools compacting and they float rather than sink. So an apple is the essential.
The second discovery was an act of desperation. I had been using those Anusol suppositories but ran out on a weekend when everything was closed. Many here would be aware of the extreme discomfort and burning sensation you can get.
Its like having acid burning you in the annus. So I know that carbon absorbs all toxins and tried one using a bit of lanolin and glove. Wow, whatever toxin it is soon gets absorbed and the pain and inflammation go away over night!
Please pass this on,I hate to think of the unnecessary suffering that people are enduring?
Thanks, Damien
RETURN TO WORK GRANTS.
I seek information on grants available to a small company to facilitate the return to work of an employee with anxiety/stress and severe IBS who has been on long term sick leave for over 2 years. I am looking to providing mentoring/counselling and conveyance to and from the office as well as an extra toilet.
There are two suggestions I can offer:
1 Access to Work <www.direct.gov.uk/disability>. This is a government
organisation which provides grants to assist people with disabilities.
There is a wide range of funding available depending on a person's needs.
Medical reports may be requested. The Company proposing to employ the
person is sometimes asked for a contribution towards the costs if any
improvements are considered of value to the employer as well. The aim is
to assist someone back to work and can involve re-arrangement of the
office to be near a toilet, taxis to and from work, personal care, office
equipment and so on.
2 Disability Living Allowance [same website as above]. This involves a
lengthy form to complete but can offer an allowance with care and/or
mobility. A chat with the Citizen's Advice Bureau might be worth while if
considering this route to talk about benefits.
It would probably be worth your client contacting Access to Work in the
first instance.
I hope this information is helpful to you and your client.
Yours sincerely
Gillian Kemp
Trustee, The Gut Trust
An invitation to join the Board of Trustees
We are looking for help in progressing the exciting new vision of the GUT TRUST and need the active participation of enthusiastic Trustees to contribute towards the work of this very special organisation.
For an application form and further details, please contact Kirsty on info@theguttrust.org
Life with IBS
Despite the financial worries of the last year, there is no evidence that IBS has increased in prevalence. This was the conclusion of a survey of Gut Trust members and Family Doctors in the late summer of this year by Peckforton Pharmaceuticals.
Stress is increasingly recognised as a significant cause of IBS. 100% of GPs and 90% of patients considered stress brought on attacks of IBS and made the condition much worse. GPs tended to emphasise the importance of stress and the brain gut axis when asked about the cause of IBS.
But IBS also adds to the stress in a person’s life, significantly undermining social activities and quality of life. When asked to describe their symptoms, patients with IBS used emotional adjectives like embarrassing, uncertain, painful, frustrating, anxious, stressful and uncomfortable and complained that of how difficult it was to lead a normal social life. It’s a vicious cycle. As detailed in our self management programme, IBS is not only the gut reaction to what happens, but it also adds to the stress and is experienced in emotional terms, much like anxiety or depression. Despite this, only 1% of those surveyed said that their IBS made them feel suicidal.
Personal relationships were rated as by far and away the greatest stress with financial worries and unemployment were secondary stressors though these often coexist alongside and contribute to relationship stress. The credit crunch did not feature prominently. One reason for this might be that members of The Gut Trust tend to be older and more financially stable than patients with IBS seen by the GP.
The average age of Trust members who responded to this survey was 60 and they had had their IBS for an average of 21 years. This emphasises that IBS that can tend to be a life-long illness. It may start in the late teens or twenties, but it can come and go in response to the trials and tribulations of life. It was thought that IBS tended to calm down as a person gets older, but that seems not to be the case, perhaps because life for the middle aged and elderly can often get more rather then less stressful nowadays. The message; IBS is often a life long condition, but it can be managed.
Most Gut Trust members are women. 82% of women and only 19% men responded to the survey. Those still in employment (a third of the patients surveyed) tend to take an average of 7.5 days off sick because of their gut, though many said they would have taken more time off if circumstances had permitted.
96% of Gut Trust members consult their GP about their symptoms and 77% have been referred to a hospital specialist. Abdominal pain, bloating, diarrhoea, urgency, flatulence and tiredness are the commonest symptoms. Most are given dietary advice and prescribed medications, with a lower percentage taking OTC medication. About a quarter of GPs advise cognitive behavioural therapy and hypnotherapy, but very few patients follow this advice, perhaps because off the difficulty in getting appointments. Hardly any GPs in this survey recommend probiotics. Patients rated the all treatment options mildly or moderately effective, marginally higher for cognitive behavioural therapy, hypnotherapy and exercise advice. This would tend to support the more individual and holistic management, implicit by the Gut Trust’s self management programme. IBS is an individual illness. One person’s IBS, the range of symptoms, what brings them on, the impact on their lives is very different from another’s. IBS can only be understood by understanding the individual and management needs to be customised to the patient’s unique conditions and needs.
Finally, it was disappointing but hardly surprising to learn that rebranding the IBS Network as The Gut Trust did not increase it’s exposure. Only 4% of GPs questioned knew of The Gut Trust, though 10 times as many had heard of The IBS Network. But the reputation of The Gut Trust is growing, the range of services we offer has been improved, new members are joining every day and patients appreciate the services The Gut Trust offers.
‘ They help you realise you are not alone.’ ‘If there was a cure for flatulence, I’d be grateful.’
Wouldn’t we all!
We’ll do our best!
Fruit and Oats better for IBS than Bran..
More evidence that soluble fibre is better for IBS than insoluble fibre.The NICE (www.nice.org.uk) Guidelines on IBS, published last year recommended soluble fibre, but not insoluble fibre for treatment of IBS. A recent randomised controlled trial carried out in primary care in Holland, showed that supplementing the diet with 10g psyllium powder provided better symptom relief than 10g wheat bran or 10g rice flour, which were equivalent. More patients in the bran group dropped in the first month of treatment because of worsening symptoms. Bijkerk CJ, BMJ 2009 339 b3154.
In a letter to the BMJ this year, Professor Peter Whorwell from Wythenshaw Hospital commented ‘ In 1994 we suggested that, at least in secondary care, cereal fibre was more likely to do harm than good in patients with irritable bowel syndrome. Now, as a gastroenterologist probably seeing more cases of severe irritable bowel than most of my colleagues, I find that the total exclusion of all cereal fibre, such as bran and brown bread, from the diet is one of the most rewarding treatment strategies I can offer.’
Soluble fiber is found in varying quantities in all plant foods, including pulses (peas, beans, lentils), oats, rye, barley, bananas, the pulp of apples and plums, prune juice, broccoli, carrots, potatoes, sweet potatoes, onions, and psyllium (ispaghula) husk, which is used as a bulk laxative.
Sources of insoluble fiber include whole grain foods, wheat and corn bran, nuts and seeds, potato skins, the skins of apples, tomatoes, pears and plums, cauliflower, courgettes and green beans.
Want to take part in an international survey?
Would you like to take part in an International Survey of Irritable Bowel Syndrome?The European Gastroenterology Federation has commissioned a working party who are undertaking an international survey of patients with irritable bowel syndrome. This is a web based survey designed to help us learn more about the irritable bowel syndrome. We are particularly interested to know how IBS which begins with an infection (Postinfectious IBS) differs from other sorts of IBS and whether this occurs at different rates in different countries of the world. If you feel that you are able to help, please go to the following url www.postinfectious-ibs.eu to complete the simple online questionnaire. We estimate this will take 30 minutes at the most. Please note that all sufferers with IBS are welcome to take part whether their symptoms began with an infection or not.
Many thanks for your help
Robin Spiller
Professor of Gastroenterology
University of Nottingham
© 2008 The Gut Trust is a business name of the IBS Network, Reg. Charity No. 1057563, Company Limited by Guarantee No. 3142642
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