Total Awareness!

Hey! Guess what, this week (December 1-7) is all about IBD (Inflammatory Bowel Disease) and since I kinda have some experience and knowledge in this area, I'm gonna tell ya all about it. :)

IBD is very different from IBS (Irritable Bowel Syndrome). IBS is a very real condition and can be quite miserable itself. This is an excerpt from CCFA (Crohn's & Colitis Foundation of America) explaining the two and how they differ.

Many people are confused about two distinct gastrointestinal disorders -- IBD and IBS. Different intestinal disorders can produce similar symptoms. Irritable bowel syndrome (IBS) is a condition that produces some symptoms similar to those of inflammatory bowel disease (IBD), but they are not the same condition, and they involve very different treatments. Therefore, getting an accurate diagnosis is essential to managing your condition properly. The following Q&A will give you an overview of IBS and how it differs from IBD. 

Irritable bowel syndrome (IBS) is classified as a functional gastrointestinal disorder, which means there is some type of disturbance in bowel function. It is not a disease, but rather a syndrome, defined as a group of symptoms. These typically include chronic abdominal pain or discomfort and diarrhea, constipation, or alternating bouts of the two. People with IBS are also more likely to have other functional disorders such as fibromyalgia, chronic fatigue syndrome, chronic pelvic pain, and temporomandibular joint (TMJ) disorder. 

IBS has been referred to by many names, including mucous colitis and spastic colitis, but these terms are inaccurate and lead to confusion about what IBS is. While the word "colitis" refers to an inflammation of the colon (large intestine), IBS does not cause inflammation. Unlike ulcerative colitis patients, IBS sufferers show no sign of disease or abnormalities when the colon is examined. 

IBS does not produce the destructive inflammation found in IBD, so in many respects it is a less serious condition. It doesn't result in permanent harm to the intestines, intestinal bleeding, or the harmful complications often occurring with IBD. People with IBS are not at higher risk for colon cancer, nor are they more likely to develop IBD or other gastrointestinal diseases. IBS seldom requires hospitalization, and treatment does not usually involve surgery or powerful medications, such as steroids or immunosuppressives. 

IBS can, however, cause a great deal of discomfort and distress, and can severely affect an individual's quality of life. Its symptoms can range from mildly annoying to disabling -- impinging on a person's self-image, social life, and ability to work or travel. People with IBS are more likely to seek health care for both gastrointestinal and non-gastrointestinal complaints compared to people without IBS. It is estimated that IBS results in direct and indirect medical costs of over $20 billion annually. 

People who have IBD also have other conditions that may or may not be caused by their particular disease. Because IBD is an autoimmune condition, we are much more susceptible to other autoimmune diseases. I have Ulcerative Colitis with a side of rheumatoid arthritis and fibromyalgia. Fun, huh. In addition to that, I also deal with depression, I was diagnosed with clinical depression which means my brain does not produce enough serotonin to keep it functioning right. My GI has said he really feels that this type of depression is directly related to the intestinal tract. He's noticed that many of his patients with IBD also suffer from depression. It's kinda nice knowing  I'm not alone but I at the same time, I hate that others must go through this too.

So I was scanning Facebook this morning and came across a very interesting article on depression. (Yes, I often get my news from my FB feed, don't judge.) The Huffington Post published this little article and while I realize it's only one psychologist's opinion, I think he might be on to something. Here's a little snippet that caught my attention.

Huff Po: Why This Psychologist Thinks Depression is an Infectious Disease
In what cases have we seen infectious agents affect mood and behavior? 
There's some literature on intestinal bacteria and probiotics. We have more than 1,000 strains of bacteria in our intestines, and it turns out that you need those to digest food. They may also play a role in our emotional states, so that people who have experienced negative emotions report improved mood when placed on a probiotic. These people may experience a reduction in depressive symptoms and anxious symptoms. So that's one example of bacteria playing a role in mood. 
There's some work on animals that goes more deeply into the potential mechanisms. There are mice that were bred to have no intestinal bacteria -- so these are germ-free, super clean mice. When you take them into a laboratory setting where you stress them out, they show a very strong stress response. But when you then put them on a diet of common intestinal bacteria, their stress response normalizes. So there's a possibility that these bacteria that we have in our guts may not only help us digest our food, but may also play a role in our emotional well-being. You could flip that upside down and say, well there's good bacteria, but maybe there's also bad bacteria that instead of lifting your mood could depress your mood...
There was one epidemiological study that looked at the prevalence of a particular parasite across 20 different European countries, and they correlated that with suicide rates, and they found a significant positive correlation. Now, we all know from any introductory science course that correlation isn't causation, so we don't know what the deal is with that, but there is a correlation there. It's also correlated with higher levels of self-reported neuroticism as a personality trait... This is all very preliminary, but I think it might be one interesting starting point.
IBD is referred to as an invisible disease meaning many times IBDers do not manifest symptoms outwardly. And it is much, much more than running to the restroom, trust me on that. We often hear "but you don't look sick" and even though we know it's not said to hurt us, it does. It really, really does.

IBDers already fight their own battle of wondering if it's all in our heads and sometimes we even have to fight the healthcare system into believing us when we don't have any outward symptoms.  
When I first started having issues, I was told it was due to some stress in my life at that time. Yes, I was in a very emotionally stressful situation because a very close friend of mine was dying plus I'm a wife, mom and domestic goddess everyday ;). It just happened to coincide with the news that her cancer was back and not going away this time. I hadn't been feeling 100% for several months already and my symptoms were becoming much more than diarrhea and frequent bathroom trips in the fall of 2003. She was given her pink slip in January and by summer I was in a full blown flare and she was nearing the end of her life. It was a very, very emotionally taxing as well as physically demanding period. All of her friends were pitching in to help her family with meals, housework and other general day to day stuff so that her last days would be a little easier on them. (I'm not trying to get a pat on the back here, it's just what was going on in my life at the time.) I was given the UC diagnosis in late July and she passed away 2 weeks later. I do not want to sound selfish or take away from the family's loss but I was really struggling after she died. My life was dramatically different because of this stupid disease and now one of my closest friends, the one who understood chronic illness and pain was gone. I think that this situation worked against me and intensified the UC symptoms however, I was sick long before her prognosis. 

I think it took close to a year before I was officially diagnosed. This isn't uncommon since the symptoms of IBD can be sporadic and not very severe in the beginning. I didn't seek help until I was bleeding rectally and in so much pain I had to go to the ER. I just kept chalking it up to something I ate or a stomach bug. You can add denial to that too, I dreaded going to the doctor to tell him I was pooping 20x a day. It's a little more embarrassing than a sore throat. In the back of my mind, I was scared there was something BAD wrong with me. UC is pretty darn serious but it's not a terminal diagnosis. 

And by the way, taking a year to get my diagnosis is about average. Believe it or not the average delay in diagnosis of Crohn's or UC is 1-3 years. It makes for a long, miserable and painful journey.


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