Re: Tina

From: Tina Shelby (
Tue Oct 12 22:28:22 1999

Hi Chris,

I too had been diagnosed with IBS and went through the high fiber suppliments and like you - I found that the high fiber increased my symptoms instead of helping them. In simple IBS - not associated with adhesions - it is true that high fiber will help control symptoms.

I saw Dr. Willam Richards at Vanderbilt in Nashville TN - he taught me some very interesting things about the bowel and adhesions. First thing he said was that the bowel does not interpret pain signals the way the rest of the body does. Once he enters the abdominal cavity - he can manipulate the bowel, cut it ect. . and the body does not intrepret that as pain. What triggers pain in the bowel - is distention. Adhesions across the bowel can interfere with the passage of gastric contents - causing distention - and therefore the perception of pain. When the bowel is "full" with fiber - and the fiber reaches a place in the bowel that adhesions have attached - preventing "normal" bowel contractions trying to move the fiber through - things get backed up - distention occurs - and pain.

The complicating factor is the IBS. A person with IBS has a much lower tolerance to bowel distention. Research done on patients with IBS and patients without IBS showed that when a ballon was placed in the person's rectum and inflated - the ones without IBS tolerated bowel distention levels at nearly 10 times greater than those with IBS. So those with IBS experienced high levels of pain with the same level of balloon distention that caused no pain in those without IBS. So those of us with IBS and adhesions - the least bit of distention can trigger major pain levels. Which also explains why we have symptoms of a partial bowel obstruction (elevate white count, vomiting, diarrhea, and a high levels of pain) that won't necessarily be picked up with x-ray.

Dr. Richards told me that I was more than likely nearly obstructing during these episodes and he could go in and take out the part of the bowel that is causing the problem - but until it actually shows up on x-ray - there isn't much he can do. He also told me that there has been no reasearch done to try and establish what is a "normal" level of bowel contractility and what is abnormal. He is actually in the process of trying to develop an instrument that can measure bowel contractility so that some range of normal can be established. He told me to stay in touch with him as he hope in about 1 years time the instrument will have been developed.

Back to your origional question about diet - a low residue diet does not usually cause the bowel to be distended like a high fiber diet/suppliments can. In a person dealing with IBS and adhesions - preventing even the least amounts of bowel distention will help to prevent major pain level.

I hope this has answered your question and I haven't confused you - forgive me if I have as the hour is late. If something I have said isn't clear or is confusing - please let me know and I will try and do a better job of explaining it.


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