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Dr.: Brain can't 'dial down' IBS pain

March 26, 2008 12:00:00 AM PDT
It's painful, chronic, and common. As many as one-in-five Americans suffers from Irritable Bowel Syndrome. IBS has stumped doctors for years, but now one local doctor believes the pain may be caused by a glitch in the brain.Food for lunch -- believe it or not, that's a good day for Jae Brodsky. And what's a bad day?

"You get up in the morning and the stomach says, 'I don't want food anymore. No solid food,'" said Brodsky.

So it's tea and broth for days at a time. Cramping, nausea, and a constant urge to use the bathroom -- sometimes 10 times an hour -- strike without warning.

"It's the uncertainty, in the sense that you just never know when you're going to be sick. Everywhere you go, anything you do, you just always have to watch out and have a plan for what happens if you get sick," said Brodsky.

More than anything, IBS is painful. But that pain could be in their head -- literally. The way most of us deal with pain is controlled like the volume on your TV. If it's pain that will benefit you -- like a shot -- we turn the volume down. But if it seems dangerous - like being burned by a hot stove - we "turn-up" the volume to react faster.

"The brain wants to do the opposite thing. It wants to maximize the gain to detect it as quickly as possible. Is this going to be something dangerous or not?" explained Emeran Mayer, MD and UCLA gastroenterologist.

UCLA researchers found a malfunction in the brains of women with IBS. They can't turn down the volume, making them hypersensitive to even mild discomfort.

"To me, it makes a lot of sense. It's one of the things that really happens," said Brodsky. "You feel everything very intensely, including the pain."

Doctors say you can retrain the brain to turn down those pain circuits, providing some relief. But the cause of the disease still stumps them.

Until then, Brodsky's backup plan includes always having a bathroom nearby.

Dr. Mayer emphasizes IBS is not just a psychological condition. However, there is a strong brain-gut component. IBS often follows an infectious illness, causing lasting inflammation and digestive enzymes.

For more information, visit www.uclacns.org

 

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