>>> FOR THOSE SUFFERING FROM IT, IRRITABLE BOWEL SYNDROME AND
CELIAC DISEASE CAN BE DEBILITATING.
IBS AFFECTS MORE THAN 25 MILLION PEOPLE IN THE UNITED STATES.
APRIL IS IBS AWARENESS MONTH, SO WE CHECKED IN WITH DR.
TUYYAD HASSON FROM HOLYOKE MEDICAL
CENTER TO LEARN ABOUT THE TREATMENTS AND OPTIONS FOR
PEOPLE LIVING WITH IBS AND CELIAC DISEASE.
>> SO IRRITABLE BOW BOWEL SYNDROME BASED ON
SYMPTOMS WHICH TEND TO BE BLOATING, DIRE WE OR
CONSTIPATION AND USUALLY WHEN YOU HAVE A BOWEL MOVEMENT OR
PASS GAS, THAT WILL GIVE YOU RELIEVE.
SO THOSE ARE THE MAIN CRITERIA THAT WE USE FOR IRRITABLE BOWEL
SYNDROME.
UNFORCELY IT IS NOT VERY SEXY, LIKE IN THE GI WORLD, LIKE COLON
CANCER BECAUSE YOU CAN'T REALLY DIAGNOSE IT WITH SUCH NEBULOUS
COMPLAINTS OR SYMPTOMS AND CAN BE VERY HARD TO DIAGNOSE.
>> AND PEOPLE CAN BE LIVING WITH IT FOR YEARS AND NOT REALIZE IT?
>> YES, AND I HAVE SEEN PATIENTS WHO WERE LIVING WITH IT 15, 20,
30 YEARS SINCE THEY WERE KIDS AND FINALLY SOMEBODY CONVINCES
THEM TO GET HELP AND GET TO THE BOTTOM OF IT AND LIVING WITH
THIS HORRIBLE AILMENT, WE GET TO THE BOTTOM AT SOME POINT.
>> HOW DO YOU HELP PEOPLE?
>> AGAIN, THERE IS NOT REALLY A CURE FOR THIS AND THAT IS WHY IT
IS NOT A SEXY DISEASE.
YOU CAN'T JUST TAKE A MAGIC PILL AND IT GOES AWAY SO THE TRIGGERS
OF IBS CAN MAKE YOUR SYMPTOMS WORSE AND THAT COULD BE DIET,
RELATIONSHIP ISSUES WITH STRESS AS A COMPONENT, MARITAL
PROBLEMS, JOB ISSUES AND THEN IT CAN GO OTHER THINGS LIKE AN
IMBALANCE OF BACTERIA IN YOUR GUT, GENETICS, LIKE A FAMILY
HISTORY OF IDEAS, BUT UNFORTUNATELY, WE DON'T REALLY
UNDERSTAND THE EXACT MECHANISMS OF IT.
ALL WE KNOW IS THIS IS VERY EXCLUSIVE BETWEEN THE BRAIN AND
THE GUT.
YOU CAN THINK OF THE GUT AS A SMALL BRAIN, YOU HAVE TWO BRAINS
AND THEY ARE TALKING TO EACH OTHER ALL THE TIME AND IF ONE
GETS DISTURBED, THE OTHER FEELS IT.
>> DO YOU HAVE TO RULE THINGS OUT IF SOMEONE COMES IN AND SAYS
THESE ARE MY SYMPTOMS BECAUSE IT COULD RULE OUT SOMETHING ELSE AS
WELL, CORRECT?
>> OH, YES, AND THAT IS WHY YOU WANT TO GO SEE A DOCTOR BECAUSE
THERE ARE SOME CONDITIONS THAT CAN MASQUERADE AS IRRITABLE
BOWEL SYNDROME LIKE CELIAC'S DISEASE, TUMOR GROWTH, CANCER,
SO YOU DEFINITELY WANT TO TALK TO YOUR DOCTOR AND MAKE SURE
THAT NOTHING ELSE IS GOING ON AND THERE ARE SOME ALARM OR RED
FLAG SYMPTOMS, LIKE BLOOD IN YOUR STOOL, IF YOU ARE LOSING
WEIGHT, POOR APPETITE, FEELING UNWELL, FEVERS, CHILLS, MAKE
SURE YOU SEE SOMEBODY.
>> AND WHO DOES IT AFFECT AND WHO ARE THE AGES?
>> MOST OF THOSE WITH IBS ARE FEMALE FOR VARIOUS REASONS WE
DON'T UNDERSTAND, TWO-THIRDS OF THEM ARE FEMALE, ONE-THIRD MALE.
IT WAS LESS COMMON IN THE 50s.
BEING 50 OR OLDER, HAVING THE SYMPTOMS, IT SHOULD SPARK
CONNECTING OUT BUT IT COULD BE ANY ETHNICITY, ANY AGE.
>> YOU THINK ABOUT TRAVELING OR WORK OR GOING TO SCHOOL, THIS
HAS TO BE DEBILITATING IN A WAY AND MAKE PEOPLE NERVOUS ABOUT
WHERE THEY ARE GOING AND HOW MUCH TIME THEY ARE GOING TO BE
THERE.
>> IT IS A HORRIBLE CONDITION AND AS A SPECTRUM OF DISEASE
THAT CAN BE MILD AND MODERATE AND THAT IS THE TIP OF THE
ICEBERG THAT WE DON'T SEE WHERE PEOPLE JUST MANAGE IT AND DEAL
WITH IT OR IT CAN BE REALLY SEVERE WHERE PEOPLE GO TO THE
BATHROOM NUMEROUS TIMES A DAY, HAVE BLOATING, SAY I LOOK
PREGNANT WITH BLOATING, IT IS EMBARRASSING.
SO IT DEFINITELY AFFECT YOUR WORK, YOUR QUALITY OF LIFE AND
WHY WE SIT WITH THE PATIENT TO HELP THEM GET THROUGH THAT.
>> HOW DO YOU WORK WITH DIFFERENT STRATEGIES FOR THAT
BECAUSE PEOPLE LIKE ON A LONG CAR RIDE OR A 5-HOUR PLANE RIGHT
MIGHT NOT BE ABLE TO DO THAT.
>> IT REALLY DEPENDS ON WHAT THE SYMPTOMS ARE, IF IT IS A DIET
THING, IF IT IS A BACTERIAL THING, WE CAN TREAT WITH
ANTIBIOTICS, IT IS DIFFERENT.
IT REALLY DEPENDS ON WHAT THE MEAN SYMPTOMS ARE AS TO HOW WE
INDIVIDUALIZE TREATMENT FOR THAT PATIENT.
SO ONE CATCH ALL MAY NOT BE FOR EVERYBODY BUT SREUTIZING IT OUT.
>> BUT IF THEY HAVE TO TALK TO THEIR KPO*EUR AND RECENT ISSUES,
IT IS A TOPIC PEOPLE DON'T WANT TO DISCUSS BECAUSE IT IS
EMBARRASSING.
>> I THINK IT IS NOT AN ISSUE BECAUSE EMPLOYERS WILL GIVE
PEOPLE MORE BATHROOM BREAKS AND THEY DON'T REALLY PENALIZE
EMPLOYEES FOR THAT.
IF THEY DO, MAYBE THAT IS PART OF THE PROBLEM, A MALIGNANT
EMPLOYER, NEED TO CHANGE EMPLOYERS, YOU KNOW?
[LAUGHTER] >> I KNOW MAY IS CELIACS DISEASE
MONTH AND THAT IS SOMETHING YOU DEAL WITH AS WELL.
CAN YOU EXPLAIN WHAT THAT IS?
>> THAT IS A PROBLEM WITH GLUTEN, A PROTEIN FOUND IN WHEAT
AND BARLEY AND YOUR BODY RECOGNIZES IT AS A FOREIGN
INVADER, STIMULATES AN IMMUNE RESPONSE AND START DESTROYING
THE LINING OF THE SMALL SOUL AND THAT CAN HAVE TERRIBLE
REPERCUSSIONS, PEOPLE CAN GET CANCERS, BLOOD CANCERS, CAN
AFFECT KIDS WITH THEIR GROWTH, ZERO SHOWERS, ATTENTION DEFICIT,
IF I TOLD YOU OWL THE -- ALL TS IT CAUSES, WE WOULD BE HERE FOR
A VERY LONG TIME.
>> YOU THINK THERE ARE PEOPLE WHO HAVE THAT AND DON'T
RECOGNIZE WHAT IT IS?
>> YES, IT COULD BE THEIR BODIES TELLING THEM AND THEY DON'T PAY
ATTENTION TO IT AND IT JUST TAKES A SIMPLE BLOOD TEST.
>> AND COULD LEAD TO SOME TYPE OF CANCER, DIABETES AS WELL, IS
THAT ALSO A RISK?
>> NO, IT IS NOT REALLY CAUSING DIABETES BUT CAN BE ASSOCIATED
WITH TYPE 1 DIABETES.
BECAUSE THE IMMUNE SYSTEM IS OUT OF WHACK, THEN ALL PARTS OF THE
SYSTEM CAN BE OUT OF WHACK AS WELL SO DIABETES, THYROID
PROBLEMS, IT CAN ATTACK YOUR SKIN AS WELL, ALL KINDS OF
THINGS.
>> WHAT IS THE BEST ADVICE YOU GIVE FOR PEOPLE WITH SYMPTOMS
LIKE THIS THAT YOU DESCRIBE?
>> TALK TO YOUR DOCTOR, MAKE SURE THEY LISTEN TO YOU.
IF THEY DON'T HAVE TIME FOR YOU, FIND SOMEONE WITH TIME FOR YOU
BECAUSE SOME OF THOSE COMPLAINTS CAN'T BE DEALT WITH IN 10
MINUTES.
IT IS ALMOST LIKE INVESTIGATING WHAT THE TRIGGERS ARE AND WHAT
IS GOING ON.