spinal stenosis
It has been quite some time since I last addressed the issue of IBS and back or lower back pain. But due to the overwhelming readership the articles I have published have gotten and the amount of reader emails I have received I feel it is time once again to address the issue and hopefully bring some notoriety to the subject. My findings over the last few years have been most enlightening.
I have long been a proponent that in some cases IBS is, or at least seems to be directly linked to spinal injury or damage. In my case it seems that way, as it does for hundreds of others who have written me, telling their stories in emails.
I want to personally thank all those that took the time to dig and find my email address. I have to admit that I usually have not made it easy. So those that did actually get an email through, and there have been many, I know had to expend some effort to actually find the email address.
Recently I got an email from a Retired Navy Master Chief who recently read my article on "Lower Back Pain and Irritable Bowel Syndrome" It is because of him, I guess that I have since been prompted to get off my keester and publish something. His story is much like my own, in fact the only difference I see in his story and my own are possibly the manner in which his back injury was delivered and our occupations.
The more email that I receive from people telling me very similar stories about their experiences with Irritable Bowel Syndrome; the more I am convinced that there is a definite link between back/neck or spinal injury and the onset of IBS.
It goes without saying that nerves that control gut operations get to and from the brain via the spinal column. So it only stands to reason that any amount of damage to those nerve corridors, conductors and conduits could and most probably do have an effect on the overall digestive system operation. It also stands to reason the worse the injury or disruption of nerve impulses to the gut, the worse IBS symptoms could or will possibly be.
I am not a doctor or spinal specialist, nor do I profess to have any knowledge but that which I personally have acquired during my own long battle with IBS, and from the accumulated knowledge of being able to compare stories sent to me by hundreds of other IBS sufferers.
There is something that I feel I must mention that I find quite profound. I have been writing and publishing in one manner or another about IBS for about 10 years now, maybe more. It was not until I published about my own observations regarding my conclusion that there was a correlation between my own spinal injury and IBS that things seemed heat up.
Once I published the first article where I suggested the connection between back pain or spinal injury and IBS, I started to get emails from many other Irritable Bowel Syndrome sufferers. Like I said, they had to dig to find my email address and be able to send me their stories, yet they did. This tells me that there has to be more than my own observation and speculation involved here.
Since the time of the first article where I asserted that there was a connection between back pain and IBS, I have received hundreds of emails from readers that were moved enough to actually take the time to tell their stories. After reading their stories, I was saddened as there was nothing I could tell them at the time that would help them. For most to whom I replied, my main suggestion was to demand that their primary caregiver at least consider the plausibility of the connection between spinal injury and IBS.
I know from my own personal experience with over 7 doctors that for them to consider something that isn't currently in their neatly categorized and cataloged list of symptoms and solutions, it is almost impossible to get them to consider anything else as a possible cause. Heaven forbid that a layperson should be able to tell a "doctor" anything. I have to admit that I only broached the subject with three physicians, and the result was less than hopeful.
Each one took a note, or supposedly took a note of what I had to say, and promptly moved on to the IBS play book. I call it that because all doctors seem to have the same mentality when it comes to IBS The only way to diagnose it is to go from test A to test B and then C and so on and on regardless of the results, regardless of how much of your money they spend on tests, tests that had they actually read your history they would have known had been done over and over already.
Until I got my last email from a reader I had almost given up hope that the medical profession would even consider the theory of spinal injury in relation to Irritable Bowel Syndrome. And I quote from the Master Chief's email, "Like you I've experienced the same symptoms for almost 15 years now. One of my PAs over the past two years introduced the thought that my problem was the result of some physical trauma." Personally I find this to be astounding, the first time I have ever encountered a person in the medical profession that would even consider such a thing. Granted the person was only a PA (physician's assistant) but it's a start. The Master Chief had previously outlined to me an accident he had been involved in many years earlier which involved a head injury, but from his description could have easily involved a spinal injury as well that may have gone undetected. Who can say for sure?
He goes on to give a brief history of his condition and then at the end of his email he says something I feel is indicative of not only my own experience, but also those of almost everyone who took the time to email me their stories. And again I quote" I've had three Colonoscopies in the past ten years with nothing found. I've done my best investigation to identify my "trigger" by taking certain foods (dairy, caffeine, breads, sugars, etc.) out of my diet to no avail. Right now I'm taking Align, which seems to help, but in no way makes life normal. I'm only 48 and I keep telling myself that I'm not supposed to feel this way at my age. I keep looking for the "silver bullet", something that will make everything all right- don't we all though."
His story could just as easily be my story, and the sad fact is I don't have any hard evidence which I can point to as progress in the right direction for IBS suffers. What I do have is a few more years of experience battling the beast. And during that time I have discovered some things for myself that have actually seemed to help me, and I stress" me". What I am about to impart is what I have done that has helped me battle IBS and made my life somewhat better over the last few years since I started publishing about back pain and IBS.
My "brand" of IBS and its cycle in my life has the typical symptoms associated with Irritable Bowel Syndrome. Things such as constipation, diarrhea, bloating abdominal pain and most of the other classic symptoms, but there never seemed to be a set pattern, and there was no way to tell which symptoms would occur. For me IBS seems to be a type of cyclic happening. Actually coming to that conclusion took me almost 20 years to figure out. Not because I am stupid, but because my back injury transformed over those number of years.
To make a long story short, I had a very bad back injury when I was a young man. At the time I was told that my only options were one, spinal fusion of L1, L2 and L3. After finding out what that would actually mean as far as mobility was concerned, I decided to go with option 2 which was to let nature take its course and see if things would heal on their own to a manageable condition.
After about a year of recuperation, I did get better. I went back to work and only had occasional problems with my back for about 15 years. Then things seemed to get worse with my back. During the 15 year period I had continued problems with Irritable Bowel Syndrome that was contributed to a gallbladder issue but never acute enough to be operable until way late in the game. That's for another article and not actually relative to the findings and conclusions I intend to draw attention to here.
As my back seemed to worsen, I began to take Ibuprofen to control the pain because it worked. I finally went to a spinal specialist who diagnosed me with Spinal Stenosis, as well as having severe degradation of the lower lumbar vertebra. Nothing I had not expected, but also not much they could do.
I was able to manage my back pain so well with continued Ibuprofen use that I didn't think about it much for quite some time. What did bother me was the increase in the symptoms of IBS. They got worse and worse and seemed to be more frequent. Instead of having symptoms that came on and lasted a few days maybe once or twice a month I now had symptoms that lasted weeks, sometimes a month or more with no relief. It really wasn't easy to identify the cycle. Because the way it happened for me, it was hard to associate the two.
I would start to notice a change in my bowel movements over a period of several days which was something I had long experienced. It might be constipation or it might be diarrhea, there was never really any pattern there. But there came a point a few years ago, that my back would cause me problems enough that I would take as many as 4 200mg tabs of Ibuprofen as often as every 4 or 6 hours because the pain was getting that bad. So now I am dealing with back pain and IBS in a much more noticeable fashion.
It took me a long time to notice that when the IBS started to rear its head, that shortly after, meaning 2 to 4 days after the IBS started up, I would have a bad episode of back pain. I would take more pain medication. My back pain would get better, my IBS would get worse. After maybe a of week of taking things easy, my back pain would settle down and later on my IBS would begin to mellow out. That is if I didn't go and do something to irritate my back again, then the IBS wouldn't let up until the back pain eased up again. And thus I associated finally a causation with my symptoms.
When the though actually occurred to me that the two things, back pain and IBS were related, I set out to prove it if to no one other than myself. I quite taking the ibuprofen altogether, instead when the pain would start I would mark that indeed the IBS symptoms had preceded the back pain. I noted that as the back pain got worst so did the IBS. Now the issue was how to treat the back pain without making the IBS symptoms even harsher.
My provisional solution was to try chiropractic's. So for a time, when I would feel the Irritable Bowel symptoms coming on, I would go see my chiropractor. By doing a lower back manipulation or sciatic relief procedure, the inflammation in my lower back would be relieved, thus the pain would go away for however long, and the IBS symptoms got better.
So for me this is what I believe has been occurring on a semi regular basis. Through normal everyday work and movement the joints in my back would become inflamed, including the many years before the pain got to the point of needing regular management. Even though there was surely inflammation in the early years, the pain was negligible or possibly even imperceptible. Let's face it; we all deal with a certain amount of pain to some degree or another in our lives. My pain was such that I could do little or nothing about it, and had the ability to ignore or accept it.
My GI tract on the other hand, I believe was more perceptive of the inflammation. So my theory is such that when the inflammation starts, nerves that control the entire GI tract are affected in so much as the signals to and from the brain via the spinal cord are either suppressed or strangled off at times. As the inflammation subsides, the nerve signals once again are able to connect properly and the Irritable Bowel Syndrome symptoms begin to diminish.
As for the fact that the IBS became worse with prolonged use of ibuprofen is an easy concept to understand. Look at all the reports of stomach ulcers and bleeding caused by ibuprofen. Continued use served to exacerbate an already inflammatory condition in the gut.
So for now this is my solution. No NSAID products of any kind if it can be helped. Narcotics and I don't mix well so even though I don't like the risks of acetaminophen products, they unfortunately have to play a small role. My back pain is managed almost entirely by chiropractic and muscle manipulation now and my IBS is markedly better.
Is it a total cure? Absolutely not, but if I had to put a percentage on how much better it is I would have to say 65 to 70% better. And yes the IBS symptoms still occur prior to my back pain onset. And because I am a rather stubborn person, I always wait to see that my back does or will actually require manipulation before I go have it done. And on occasion, about 1 out of every 4 episodes of IBS, there will be no back pain and the symptoms will subside in a day or two.
Is this to say that there is a deeper rooted causation for my particular Irritable Bowel Syndrome symptomology? I cannot say with any certainty. But I do believe that the majority of the time it is directly related to my ongoing problems with my spine. And it may be that even though there is no perceptible back pain for the small amount of times that the symptoms occur without the back pain, that the inflammation is indeed still the root cause. Even having said that, I never go in for manipulation right away when the IBS symptoms begin, I always wait for the back pain begins or get to a moderate level.
Stubborn also translate into cheap. I don't like paying for those $80 to $120 visits to the chiropractor. So how long I suffer with the recurring symptoms each time is relative to the amount of money I have, or am willing to part with and how quickly I am willing to do it. Insurance only goes so far.
The conclusion I have come to for myself. And I cannot stress enough that every case is going to be different. But for myself, I am certain that my back injury plays a major role in my Irritable Bowel Syndrome. I am further convinced that the taking of NSAID pain relievers made my condition even worse.
I further conclude that by finding alternative methods to control pain such as chiropractic manipulation and muscle massage, I have been able to significantly decrease the severity and also the frequency of my IBS symptoms.
So, it might be worth your while to investigate for yourself these things I have talked about in connection with your own IBS symptoms. I have no affiliation with any chiropractic association or massage therapy entity that would compel me or compensate me for stating the things I have. Even if you don't feel you have a spinal injury or condition where by inflammation of the spine might be occurring, it might not hurt to seek out a local chiropractor and have an exam or just go in for a through manipulation and judge for yourself the results.
Keep in mind that for many years I had pain that I was able to almost totally ignore. We train ourselves to live with pain, not that it's what we should be doing, but it happens. So it might be possible that others who have IBS also have ignored back, spine or neck pain that could be a contributing factor in the Irritable Bowel Syndrome symptoms that are exhibited in their particular "brand" of IBS.
I do not contend that the information that I have given about what has been helpful for me will be the solution for everyone or for anyone for that matter. But I do think it's important to keep up a dialog of sorts to keep hope alive. If you have suffered long with the symptoms, you know own too well how hard it is to find any kind of practical medical support and how little hope that the medical profession has given us as far as any type of cognitive answers regarding causation or subsistence of symptoms.
My hope is that the information will lead other IBS surfers to reexamine their own "brand" of IBS and possibly follow a loosely carved path to find at least some relief. Further I would not try to assert that my symptoms are completely gone, nor do I conclude that all of my IBS symptoms are related to my spinal condition. But to me, the evidence is too compelling for me not to concede that my IBS is at least moderately connected to spinal injury.
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