Irritable bowel syndrome fortunately does not cause permanent intestinal damage. However, it can  cause serious issues for some people. Unlike more severe intestinal disorders, such as Crohn’s disease, ulcerative colitis and irritable bowel disease, people with irritable bowel syndrome do not have an abnormal structure of their bowels. These diseases cause intestinal inflammation and increase the risk of colorectal cancer, but irritable bowel syndrome does not. People with serious cases of irritable bowel syndrome may have difficultly traveling or experience significant discomfort that interferes with work or their social lives.

Types of Irritable Bowel Syndrome

There are three different classifications of IBS, based on the affect on the colon and the overall elimination process. They are:

Diarrhea Predominant IBS- this form is characterized by mainly loose stools. The individual may have an urgent and often uncontrollable urge to relieve themselves and the output is watery and without shape. This type can lead to dehydration, due to a continuous loss of liquid.

Constipation Predominant IBS- consists of infrequent or hard to pass stools, which may cause pain, gas, bloating-especially after meals, headache, exhaustion and acid reflux.

Alternating IBS occurs when an individual experiences both diarrhea and constipation in alternating cycles. This can be one of the most physically taxing and hard to treat types of IBS because of the unpredictability of the symptoms.

Similar Disorders

Not to be confused with Irritable Bowel Syndrome, there are other, sometimes similar bowel disorders. Amongst them are:

Crohn’s Disease is an inflammatory disease of the bowel that is thought to be autoimmune in nature, meaning that the body mistakenly attacks healthy tissue in the colon. Crohn’s can be severely debilitating and can affect any and every part of the digestive tract, from the mouth to the organs of elimination. The illness has a hereditary component, but a malfunctioning immune system and environmental pathogens are highly implicated in the development of Crohn’s Disease. Symptoms vary based on the individual and the severity of the illness and include abdominal pain, bloody stools, ulcers, scarring of the bowel wall, weight loss, skin abnormalities, exhaustion and arthritis pain.

Celiac Disease is an autoimmune disorder where the body attacks the lining of the small intestines. Specifically, an acute sensitivity to gluten (found in wheat, barley and rye) causes the immune system to attacks the villi which line the small intestine and are responsible for nutrient absorption. Celiac Disease is more commonly found in individuals with other autoimmune disorders and illnesses, such as Lupus, Rheumatoid Arthritis and Thyroid Disease. Symptoms include malnourishment, diarrhea or constipation, gas and bloating, bloody or fatty stools and depression.

Colitis is inflammation and swelling of the large intestine. An extremely painful disease, Colitis can be triggered by a number of things, including food poisoning, a virus, bacteria, parasitic infestation, lack of blood flow to the colon and prior radiation treatment. Individuals with Colitis may feel the constant need to empty their bowels and may also experience bloody stools. Other symptoms include abdominal pain, fever, chills diarrhea and dehydration.

Leaky Gut Syndrome is a new diagnosis that not all mainstream physicians acknowledge. Essentially, in patients with Leaky Gut, there is damage to the lining of the intestines, which allows matter to escape into the bloodstream causing a variety of symptoms. Substances that are able to pass through the lining include particles of undigested food, toxins and bacteria and undigested fat and protein. As it is not normal for these substances to be found in the body, the immune system reacts to them as foreign invaders and attacks, prompting an inflammatory response. Over time, this ongoing inflammation can cause mild to severe symptoms, including autoimmune response, skin rash, joint pain, gas and bloating, food sensitivities and severe pain.

How Does the Colon Function?

To fully understand this condition, it is important to have a working knowledge about the colon and its functions. This will allow you to readily identify abnormal symptoms and seek medical assistance.

The colon is also known as the “large intestine” and is attached to the end of the small intestines. While the small intestines can measure up to 23 feet in length, the colon is much shorter at approximately five feet. Muscular in nature, the colon pushes digested food towards the rectum for elimination. The colon is the last stop for digested food before it is excreted and works to remove water, salt and nutrients that will be used in the body. The remaining matter is what is known as stool.

Causes of Irritable Bowel Syndrom

While the exact cause of IBS is not known in the mainstream medical community, there are some indicators of what can contribute to development of the disease, including:

Post-infectious IBS refers to symptoms that manifest after a recognized colon infection, especially a severe case of bacterial gastroenteritisis in the form of E-coli, Shigella and Salmonella poisoning.  Statistics are varied, with a reported 4%-32% of intestinal infections progressing to IBS. In many of these cases, the immune system attacks the mucous lining of the intestines causing inflammation and allows food and waste particles to escape the colon into the body. After resolving the initial infection, some patients are able to treat the resulting IBS symptoms effectively in a short period of time, while others experience long term discomfort over a period of years. Post-infectious IBS is more prevalent in women than men and has been found more frequently in those suffering from a high level of stress.

Bacterial overgrowth is another possible cause of Irritable Bowel Syndrome, which in a study conducted by Ceders-Sinai Medical Center, showed that 78% of patients had excessive bacterial overgrowth. The digestive tract is host to millions of bacteria which maintain a delicate ecosystem and help to regulate digestion and food absorption. There are two types of bacteria- good and bad bacteria. In its optimal state, the good bacterium keeps the bad from taking over and causing problems. In the case of bacterial overgrowth, this balance has been upset. This can be due to a number of reasons, including:

• Previous use of antibiotics, as they eradicate both good and bad gut bacteria indiscriminately
• Chronic low levels of stomach acid
• Taking immune suppressing drugs
• Parasitic infections
• Drinking contaminated water
• Food intolerances
• Excessive alcohol consumption
• Slow moving bowels

Stress has been indicated as a factor in IBS. Many of the body’s hormones and immune function is centered in and affect the gut, thus stress can have quite an impact on bowel function. One poll showed that approximately 70% of people realized tangible changes in their bowel function when they are stressed. Things such as relationship problems, family issues, loss of a loved one and work pressure can all bring about the symptoms of IBS.

Serotonin levels in the brain which affect mood have been shown to impact IBS symptoms and the severity thereof. The hormones of the brain and intestinal function is linked in what some call the brain/gut axis, meaning that the state of one interacts with and affects the other at some point. Feelings of depression, anxiety and hyperactivity can have a direct impact on the colon inducing cramping, gas, diarrhea, constipation and sluggish elimination.

Female reproductive hormones have also been seen to influence the severity of IBS symptoms. It is not necessarily the estrogen and progesterone released during the ovulation cycle that has an impact, but it has been observed that during a woman’s menstrual period, she is more likely to experience an increased number of bowel movements. For those that suffer from existing bowel dysfunction, this can be a highly uncomfortable time of month. This, in addition to the fact that more women than men suffer from depression-which is also a factor in IBS, may account for the 2:1 ratio of women versus men with this condition.

Blastocystitis is the condition in which single cell microscopic parasites called B. hominis are present in the digestive tract and have multiplied greatly, causing the symptoms of IBS. Often found in people with no symptoms, B. homonis parasites can exist in the bowels without irritating the individual. However, it is thought that when they are combined with other parasites or infectious agents that IBS symptoms tend to occur. Some of the most common symptoms of Blastocyctitis including diarrhea, bloating, cramps, flatulence, and anal itching. It is thought that B. hominis infections are the result of poor bathroom hygiene and possibly, oral/fecal contamination.

Risk Factors

Women and younger people are at greater risk for developing irritable bowel syndrome. More than eight out of 10 people in the United States who have irritable bowel syndrome are women, according to the American College of Gastroenterology.

Teenagers and young adults are frequently victims of irritable bowel syndrome. More than 50 percent of irritable bowel syndrome sufferers developed the condition prior to turning 35 years old. However, people older than 35 years of age can develop irritable bowel syndrome. Stress is often a key factor in development of irritable bowel syndrome among older adults.

People whose family members suffer from irritable bowel syndrome may be at an increased risk. Doctors do not know if genetics play a role in irritable bowel syndrome or if a family’s environment is a factor, or if both can increase the risk for irritable bowel syndrome.

However, it has been observed that people with a first-degree relative with irritable bowel syndrome is at a higher risk for getting condition as well.

Symptoms

Irritable bowel syndrome causes a range of gastrointestinal symptoms that most people find tolerable with treatment and lifestyle modifications. Symptoms can be mild to severe. Mild symptoms may  sometimes interfere with daily activities but do not happen frequently. Moderate symptoms typically happen more often, are more intense and are more likely to interfere with normal activities. Only some people experience severe, disabling symptoms that are intense. Irritable bowel syndrome can be a serious problem for people with severe symptoms.

Abdominal pain, discomfort, bloating, gas and flatulence are the most common symptoms among people with irritable bowel syndrome. People often feel an urgency to defecate. Morning rushes to the bathroom are common. These people may also have to use the bathroom several times after waking up and frequently during breakfast or after eating. Other common problems include changes in bowel movements and loss of appetite.

Abdominal pain generally follows certain patterns in people with irritable bowel syndrome and is often linked to bowel movements. Once a person has a bowel movement, the pain in their abdomen along with other symptoms may go away. Pain can also begin alongside noticeable changes in the frequency of bowel movements or changes in the appearance of stools.

Changes in elimination patterns or stool appearance can also be linked to constipation or diarrhea in people with irritable bowel syndrome. When a person with irritable bowel syndrome is constipated, their symptoms may include:

• Cramping during bowel movements
• Dry, hard stools
• Experiencing three or fewer bowel movements within one week
• Inability to pass stools or only being able to pass a small amount
• Small, pellet-like stools
• Strain during bowel bowel movements

A person with irritable bowel syndrome experiencing diarrhea may exhibit symptoms, such as:

• Feeling of urgency to have a bowel movement
• Having three or more eliminations in one day
• Ribbony stools
• Watery stools

Symptoms often occur following meals. Some irritable bowel syndrome sufferers may present with symptoms of both constipation and diarrhea. Other people may alternate between the two or experience only constipation or diarrhea.

Other symptoms of irritable bowel syndrome include a clear or whitish mucus in stools or the feeling that a person has not completed their bowel movements. However, symptoms vary by individual. Most people’s symptoms are mild, though they may worsen overtime even if the symptoms disappear for a brief time.

Irritable bowel syndrome is not a disease, but it is a chronic disorder. This means that symptoms can come and go but a person may have to deal with the symptoms recurrence for years. The symptoms of irritable bowel syndrome may have other causes. People are more likely to have irritable bowel syndrome if their symptoms last for more than six months initially and they experienced symptoms at least three days per month during the previous three months.

Many people suffering from irritable bowel syndrome also experience psychological problems. As many as 60 percent of people with irritable bowel syndrome have psychological symptoms, such as  depression and anxiety. The brains of people with irritable bowel syndrome and psychological symptoms are often low in the neurotransmitter serotonin, which plays a role in mood.

Irritable bowel syndrome may interfere with the body’s ability to absorb nutrients, leading to symptoms of malnutrition. Not everyone who is malnourished experiences issues, but common symptoms include dizziness, tiredness and weight loss.

Diagnosis

Symptoms of irritable bowel syndrome are inconsistent. Due to the inconsistency and because there are no characteristically abnormal tests for irritable bowel syndrome, diagnosing the condition is difficult. Doctors review peoples’ medical histories and perform physical examinations when determining if irritable bowel syndrome is the cause behind their patients’ distress. The most important symptoms doctors consider when irritable bowel syndrome is suspected are abdominal discomfort or abdominal pain that has lasted a minimum of 12 weeks. The 12 weeks do not need to be consecutive.

Doctors also look for two of the following symptoms to diagnose irritable bowel syndrome:

• Abdominal distension
• Feeling as if one cannot completely empty their bowels
• More or less frequent bowel movements
• Mucus in stools
• Straining during elimination
• Urgency to defecate
• Change in stool consistency, such as normal stools one day and then hard or loose stools another day

Rome Criteria

Another method for diagnosing irritable bowel syndrome is known as the Rome criteria. A group of investigators of gastrointestinal diseases from around the world met in 1992 in Rome to determine a criteria for diagnosing irritable bowel syndrome. This became known as the Rome criteria. It was modified in 1996 and then again in 2006. The original criteria is called Rome I. The 1996 version is the Rome II criteria and the 2006 version is called Rome III.

Some doctors may use Rome I or II, but Rome III criteria is more commonly applied. Rome III criteria states that patients must have abdominal discomfort, not pain, a minimum of one time each week for at least two months. Patients must also present with two out of three other features to be diagnosed with irritable bowel syndrome. The additional features include:

• Change in the form of stools
• Feeling of relief after passing stools
• Increased or decreased frequency of bowel movements

The Rome III criteria does not take into account symptoms that may indicate a problem other than irritable bowel syndrome. These include pain or discomfort in the upper abdomen, more frequent flatulence and abdominal distension.

The Rome criteria also states that there must not be evidence of other conditions that could cause symptoms of abdominal discomfort when diagnosing irritable bowel syndrome. These alternate causes include obstructions, tumors, inflammation or a metabolic cause.

Diet

Irritable bowel syndrome may be linked to a lactose intolerance. Lactose is a sugar found in dairy products. Encouraging patients to abstain from eating dairy is one way to determine if a lactase deficiency is causing symptoms. Lactase is an enzyme the body uses to digest lactose. A deficiency in this enzyme results in difficulties digesting lactose, which could lead to symptoms similar to those caused by irritable bowel syndrome. Lactase deficiency is also called lactose intolerance or milk intolerance.

Doctors may ask patients to avoid eating any lactose-containing foods for two weeks to see if this resolves or lessens symptoms. Doctors may also use a breath test to diagnose a lactase deficiency.

Diagnostic Tests

Diagnosing irritable bowel syndrome sometimes involves tests to rule out other issues that could explain symptoms. Doctors may perform blood tests to check for evidence of celiac disease. A blood test also shows if a person has a low blood count, which indicates anemia. Anemia  is a condition caused by various problems that lead to insufficient amounts of healthy red blood cells. The body needs red blood cells to carry oxygen throughout the body. Anemia is linked to various gut disorders. Therefore, the presence of anemia indicates that irritable bowel syndrome may not be the cause of a person’s symptoms.

Doctors can also check for an infection by taking a stool culture. Stool cultures may reveal evidence of a malabsorption disorder as well.

A test called an erythrocyte sedimentation rate (ESR) is sometimes done to check for inflammation. This is a common blood test. A similar blood test that also checks for inflammation is called a C-reactive protein (CRP). Doctors use these tests because if inflammation is present then people are unlikely to have irritable bowel syndrome. Other gut disorders can lead to bowel inflammation, but irritable bowel syndrome does not.

In some cases, doctors may perform a procedure called a colonoscopy, which allows them to examine the colon for signs of gastrointestinal conditions and diseases, such as Crohn’s disease, ulcerative colitis or colon cancer. A colonoscopy involves a flexible tube equipped with a camera going into the anus and through the length of the colon.

A colonoscopy is typically used for patients who have bloody stools, unexplained weight loss, abnormal blood test results or who first presented with irritable bowel syndrome symptoms over the age of 50. These are some of the indicators that a more serious condition is behind a patient’s symptoms. Other indicators that prompt doctors to use additional tests include:

• Abdominal pain that is not relieved by a bowel movement
• Chronic diarrhea
• Fever
• Nausea
• Rectal bleeding
• Recurrent vomiting

Patients who do not have any of the above red flag indicators of more serious conditions may receive treatment for irritable bowel syndrome without further testing. However, if they do not respond to treatment doctors generally then perform tests to rule out other conditions.

Another test involving the colon that doctors may order when irritable bowel syndrome is suspected is called a flexible sigmoidoscopy. This test uses a flexible, lighted tube called a sigmoidoscope to view the sigmoid, which is the lower portion of the colon. Signs of malabsorption or abnormalities of the sigmoid show up during this exam.

Computerized tomography (CT) scans of the pelvis and abdomen are used to examine the internal organs to look for signs of disorders that cause symptoms similar to irritable bowel syndrome. CT scans make cross-sectional X-ray images that allow doctors to see a range of potential problems.

Treatments for Irritable Bowel Syndrome

Treatments for irritable bowel syndrome include medications for the condition and medications to manage the symptoms. Some people’s irritable bowel syndrome is not severe enough to require conventional treatment. As many as 70 percent of people who suffer from irritable bowel syndrome do not receive medical care for symptoms. They can tolerate their irritable bowel syndrome with diet and lifestyle modifications.

People whose irritable bowel syndrome is moderate to severe will require medication. The majority of conventional treatments for irritable bowel syndrome sufferers involves managing symptoms. Some medications are over-the-counter drugs while others are only obtainable with a prescription.

Medications for Irritable Bowel Syndrome Symptoms

Bowel spasms caused by irritable bowel syndrome can be exceptionally painful and medications may be needed to relieve these spasms. Anticholinergic medications affect the autonomic nervous system and can inhibit activities that cause bowel spasms. These medications can relieve diarrhea, but may make constipation worse.

Antispasmodic medicines may also help spasms in the muscles of the intestines and relieve the pain they cause. A doctor can prescribe one of several antispasmodics, such as mebeverine or hyoscine. The medications work differently so if a person does not respond to one type of antispasmodic medicines then a doctor may prescribe a different one. People take these medicines as needed when they experience pain. The medications can reduce pain but are unlikely to make it disappear completely. Taking these drugs for about a week at a time is normal. Antispasmodic medicines can prevent irritable bowel syndrome pain that occurs post-meals if taken before eating.

Antidiarrheal medications may relieve diarrhea related to irritable bowel syndrome. People can purchase antidiarrheal medications like loperamide (Imodium) over-the-counter.

Some people with irritable bowel syndrome suffer also from depression. Doctors may treat depression with antidepressant drugs, including selective serotonin reuptake inhibitors and tricyclic antidepressants. Selective serotonin reuptake inhibitors include well-known antidepressants, such as paroxetine (Paxil), fluoxetine (Prozac) and sertraline. These antidepressants may relieve pain and constipation as well.

Tricyclic antidepressants are also effective for reducing abdominal pain and diarrhea. Tricyclic antidepressants include imipramine, trimipramine(Surmontil), amitriptyline (Elavil) and desipramine (Norpramine). For people with those symptoms who are not depressed, lower dosages of tricyclic antidepressants may be prescribed.

Some antidepressants may cause side effects including, drowsiness, diarrhea and constipation.

Infections may cause irritable bowel syndrome, though this has not yet been established. Some doctors therefore believe that antibiotics may help people who have an overgrowth of bacteria in their intestines.

In addition to medications, doctors may recommend fiber supplements to relieve constipation associated with irritable bowel syndrome. Fiber from supplements helps to soften stools so they pass more easily through the intestines and out of the body. Fiber supplements include psyllium (Metamucil) or methylcellulose (Citrucel). The American Dietetic Association recommends 20 to 35 grams of fiber daily for adults, which can come from food or supplements.

Medications for Irritable Bowel Syndrome

Only two medications are known to effectively treat irritable bowel syndrome. These approved medications are only prescribed when other treatments have failed. The two medications include lubiprostone (Amitiza) and alosetron (Lotronex).

Lubiprostone is a chloride channel activator that is effective for increasing fluid secretion in the intestines, which assists in passing stools. The medication is approved only for women. It is generally given to women with severe constipation. It is not approved for use in children.

Lubiprostone causes side effects, including diarrhea, abdominal pain and nausea. More research is needed to fully determine if the medication is safe and effective.

Alosetron may help to relieve diarrhea associated with irritable bowel syndrome. It is also approved only for women. Alosetron works by promoting relaxation of the intestinal muscles. This slows the passage of stool through the lower bowel.

Alosetron had been approved for use but was then withdrawn from the market because of its side effects and suspected link to serious complications. The U.S. Food and Drug Administration approved alosetron for use again, but with restrictions. Only doctors who are gastroenterologists and enrolled a special program are allowed to prescribe alosetron now.

Men, children and teenagers should use other medications, diet changes, therapy or supplements instead of these irritable bowel syndrome medications. Prescribing either of these medications is rare even among adult female patients with irritable bowel syndrome.

Psychological Therapy

Psychological therapy may lessen symptoms of irritable bowel syndrome. Typically, people who have moderate-to-severe symptoms that have not responded to other treatments and symptoms that are suspected of being linked to psychological factors are candidates for psychological therapy. Yet there are different types of therapy. Some types of therapy may work better for certain individuals or for different symptoms.

People who are depressed or suffer from stress may find that counseling helps more than antidepressants. Combining the two may be the best way to treat irritable bowel syndrome in some individuals.

Talk therapy can be effective for treating people with irritable bowel syndrome and stress. Talk therapy may help individuals lower their stress levels. This type of treatment may be used in conjunction with other types of therapy, such as cognitive behavioral therapy or interpersonal therapy.

Cognitive behavioral therapy emphasizes observing and changing people’s thoughts and actions. Therapists show their patients how perceptions of their lives and even of themselves can be inaccurate. Through changing perceptions, cognitive behavioral therapy may relieve irritable bowel syndrome symptoms and improve quality of life.

Interpersonal therapy for irritable bowel syndrome treatment focuses on how people’s emotions affect their irritable bowel syndrome symptoms. Therapists teach their patients techniques for stress management and relaxation. Interpersonal therapy is also known as psychodynamic therapy.

Hypnotherapy

Hypnotherapy is the use of hypnosis to put patients into an altered state of consciousness, or trance. Hypnotherapy is deeply relaxing. Studies show that gut-directed hypnotherapy, which focuses on relaxation of the intestines, can relieve irritable bowel syndrome symptoms by relaxing muscles in the bowels.

Patients experience not only relief from physical symptoms, but also improvement in emotional symptoms of irritable bowel syndrome. People with irritable bowel syndrome report improved emotional quality of life after receiving hypnotherapy sessions.

Dietary Modifications

Many people experience a reduction in irritable bowel syndrome symptoms through changing their diet and eating habits. A helpful tool for irritable bowel syndrome patients is a food journal. Patients record what they eat and when, plus if they experience any irritable bowel syndrome issues. The journal can identify harmful patterns or specific foods that cause symptom flareups.

Working with a registered dietician often results in improvements as well. A dietician may recommend  substituting certain foods for others and eliminating trigger foods. For example, a person who has a lactose intolerance and has symptom flareups after consuming dairy products may be able to tolerate yogurt containing live bacteria cultures. The bacteria in some yogurt can make digesting lactose easier. For people who need to eliminate dairy completely, a dietician helps to ensure patients still get adequate amounts of nutrients like calcium from the rest of their diet.

Some people may experience relief from eating smaller meals. Large amounts of foods may lead to diarrhea and abdominal cramps. The body digests smaller portions more easily than large meals. Consuming six small meals instead of a large breakfast, lunch and dinner helps some irritable bowel syndrome sufferers. Eating more slowly may help too as eating quickly can cause people to swallow air, which leads to abdominal gas. Chewing gum is another time people can swallow air.

Increasing fluid intake may improve irritable bowel syndrome. People with diarrhea can particularly benefit from drinking six to eight glasses of water daily, though this is a good rule of thumb for most people. Substituting regular water for carbonated water and other carbonated drinks can relieve abdominal gas and discomfort.

Adding more fiber foods to the diet may be effective for irritable bowel syndrome, especially for sufferers who have constipation. Increased fiber intake can also reduce diarrhea and pain. High-fiber diets can keep a colon mildly distended, which sometimes prevents colon spasms. Fiber helps retain water in the stool so that stools are soft and can pass easily through the colon. Whole grain products, such as cereals, pastas and breads, are high in fiber. Vegetables and fruits are also rich in fiber, though people with irritable bowel syndrome are sometimes advised to limit their fresh fruit intake to three portions a day.

However, not all fiber is the same. Some fiber is water soluble and other fiber is insoluble. Insoluble fiber helps with constipation because if adds bulk to stool, which lets stool pass more quickly. Whole grains, seeds, nuts, some fruits and vegetables contain insoluble fiber. Some irritable bowel syndrome sufferers may benefit more from adding soluble fiber to their diet. Soluble fiber slows digestion. Oats, dried beans, citrus fruits, potatoes and barley are good sources of soluble fiber.

Some people experience abdominal bloating and gas when first switching to a high-fiber diet, but these symptoms typically resolve themselves in a few weeks. Gradually increasing fiber by two to three grams daily decreases the risk of abdominal bloating and gas.

People with celiac disease should increase their fiber intake from fruits, vegetables and grains that do not contain gluten, such as buckwheat, rice and quinoa.

Irritable bowel syndrome sufferers who experience flatulence and abdominal gas may find relief from eliminating high-gas foods from their diet. Foods that may cause abdominal gas include:

• Broccoli
• Cabbage
• Carbonated beverages
• Cauliflower
• Raw fruits

Other raw vegetables and dishes that contain mainly raw produce, like salads, can also lead to abdominal gas.

Increasing the amount of oats people eat can also reduce flatulence and abdominal gas. Oatmeal and porridge are two common dishes that are full of oats. Taking up to one tablespoon daily of linseed can also help.

People with irritable bowel syndrome and diarrhea may benefit from avoiding foods known to stimulate the intestines. Stimulatory foods linked to diarrhea include:

• Alcohol
• Caffeine
• Dairy
• Fatty foods
• Sorbitol
• Sugary foods
• Xylitol

Sorbitol and xylitol are artifical sweeteners often used in sugar-free candy and chewing gum. They may also be used in diabetic foods and weight loss products.

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Alternative Treatments

Alternative treatments bring relief to many people with irritable bowel syndrome. These treatments may not be the first choice on medical professionals, but are often recommended as complementary therapy to support regular irritable bowel syndrome treatment therapies.

Stress Reduction

Stress reduction is also a known factor in gut and bacterial health. When under chronic stress, the mechanisms that maintain harmony in the intestinal tract function less optimally and can break down altogether. What was previously described as the brain/gut axis postulates that there is a definite correlation between the psychological and mental state and digestive health. People who consistently maintain a high stress lifestyle, with the attendant hormones that it provokes are at risk for bacterial imbalances and IBS. Finding ways to minimize and deal more effectively with stress can greatly reduce symptoms. Such means can include, journaling, the Emotional Freedom Technique or Psychotherapy.

Acupuncture

Acupuncture is popular with irritable bowel syndrome sufferers. Even though it is an alternative therapy and there is no conclusive evidence that acupuncture is effective for irritable bowel syndrome, acupuncture is proven to reduce chronic pain.

Studies show mixed results for use of acupuncture as an irritable bowel syndrome treatment, but some people do report feeling better after receiving acupuncture treatments. Acupuncture needles placed in specific areas of the body may stimulate electromagnetic signals that boost the body’s healing processes or cause pain-reducing chemicals to be released.

Acupuncture has been used for thousands of years as part of traditional Chinese medicine. However, even in China acupuncture is used along with other therapies.

Colonic Irrigation

Colonic Irrigation is also employed by holistic practitioners to help alleviate the symptoms of Irritable Bowel Syndrome, specifically constipation. By introducing a flow of water directly into the colon by way of the anus, old impacted fecal matter is broken down and swept away. Many individuals find that after 3-7 colonic sessions-in addition to diet changes- they no longer suffer from chronic constipation.

Oils

Various oils may help to calm the intestines and relief symptoms of irritable bowel syndrome. Oils come in capsule and liquid supplements.

Peppermint oil is a natural method to treat irritable bowel syndrome that studies show is more effective for symptom relief than a placebo. However, peppermint oil may not work for everyone and some people experience heartburn.

Evening primrose oil derived from the seed of a wildflower may also be beneficial for irritable bowel syndrome. Women whose irritable bowel syndrome symptoms become worse during their menstrual cycle are most likely to experience relief from evening primrose oil. The oil may cause side effects, including headache, upset stomach and rash.

Borage oil may be beneficial for some people as well. This oil comes from a common weed.

Castor oil can help as topical applications. Castor oil packs applied to the skin may reduce muscle cramps. Experts recommend covering packs with a cloth and then putting a heat source on top of the pack for 30 to 60 minutes.

Probiotics

Probiotics are beneficial bacteria. Eating probiotic foods or taking probiotic supplements can help restore an ideal balance of bacteria in the digestive tract. Some people have an overgrowth of harmful bacteria in their gut that may contribute to irritable bowel syndrome. Probiotics can inhibit bacteria overgrowth and thus improve irritable bowel syndrome.

Some studies show that people with irritable bowel syndrome who use probiotic treatment experience significant improvement in quality of life and fewer irritable bowel syndrome. Probiotics can reduce diarrhea. Specifically, the cultures Lactobacillus acidophilus and Bifidobacteria infantis may be the most beneficial for irritable bowel syndrome.

Yogurt is a well-known probiotic food, but other foods may contain probiotics too. Cheese, milk and frozen yogurts can also have probiotic bacteria. However, this is only true of products labeled “active cultures” or “containing live bacteria.” Products that do not contain live bacteria do not help the digestive system.

Herbs

Herbal remedies are popular among irritable bowel syndrome sufferers. A registered herbalist may recommend different herbal remedies depending on the individual and what other treatments are being used. Herbalists may recommend herbal blends as well.

Sometimes, blends of 20 to 40 herbs in one supplement are used successfully as herbal remedies for irritable bowel syndrome. A mixture of herbs like ginger, wormwood, dan shen and bupleurum have been shown to decrease irritable bowel syndrome symptoms.

Peppermint is also a commonly used herb for irritable bowel syndrome due to its calming effect on the colon. A more relaxed colon is less likely to produce abdominal discomfort and diarrhea. Herbalists frequently recommend peppermint use along with other herbs, not on its own or for prolonged periods of time. Experts say that enteric-coated peppermint capsules are less likely to cause heartburn than other peppermint supplements.

Supplements

Melatonin supplements may be beneficial for irritable bowel syndrome. Melatonin is a hormone that regulates the body’s circadian rhythms necessary for sleep. Melatonin also controls other hormones. It is secreted by the pineal gland in the brain, but not everyone’s brains produces enough of the hormone. Taking two to five milligrams of a melatonin supplement before bedtime can improve sleep and reduce irritable bowel syndrome symptoms.

Ground flaxseed supplements can reduce symptoms of irritable bowel syndrome too. Six to 24 grams daily can relieve constipation. Taking flaxseed may also decrease abdominal bloating and discomfort.

Homeopathic Medicine

Homeopathic medicine, also called homepathy, is an alternative medicine that may be helpful for some people with irritable bowel syndrome. Homeopaths may recommend natural remedies that come from plants or animals. Some of these treatments may be similar to herbal remedies or supplements prescribed by other alternative health practitioners, but homeopathic medicine operates on unique principles.

Homeopathic medicine follows two main principles to treat patients. The principle of similars suggests that conditions may be cured using a substance that causes similar symptoms to the condition. The principle of dilution states that lower doses of medications produce greater effects. Homeopaths may significantly dilute irritable bowel syndrome remedies to the point where the final solution may not even contain any of the healing substance. Homeopathic practitioners believe that diluted remedies still contain the essence of the cure. This stimulates the body to heal itself.

There have not been enough studies on homeopathic medicine for irritable bowel syndrome to decide conclusively whether it may help sufferers.

Chiropractic Treatments

Some irritable bowel syndrome sufferers find relief from chiropractic treatments. Chiropractors perform spinal manipulations that may help irritable bowel syndrome by providing a balancing effect on the nerves that send impulses from the brain to the intestines.

Exercise

Exercise can be an effective means of regulating bowel function and minimizing some of the symptoms of Irritable Bowel Syndrome. Often, if a person is sedentary, their bowel function decreases, leading to constipation, trapped gas and pain. Exercise helps the body to move waste through the intestines and effectively expel toxins. If an individual is unable or unwilling to engage in strenuous exercise, even something such as a brisk walk after meals can be beneficial to colon health.

Massage, especially colon massage techniques can be a beneficial way to stimulate sluggish digestive system and move waste through the body. For the best results, your masseuse should be trained in this area, which is called Deep Abdominal or Colonic Massage. During the session, the practitioner will massage in a focused, deep and rhythmic manner and will concentrate on the abdominal cavity, lower and upper back and shoulder area. This therapy has been effective in reducing a wide range of symptoms, from Irritable Bowel Syndrome to menstrual problems. For obvious reasons, this should not be attempted during pregnancy.

Cranial-sacral and bio-feedback therapy

This has been shown to be effective in dealing with stored emotional issues or trauma that may unknowingly be stored in various parts of the body. A practitioner will work to identify blockages and help a person to confront and move through emotions that may be affecting their body’s ability to function. As stress and trauma cause changes in hormonal secretion and neurotransmitter function, as well as immune system effectiveness in the brain/gut axis, it is highly likely that stored negative emotions can cause IBS.

Additional Treatments

A few other alternative treatments may help make irritable bowel syndrome more tolerable. Heat reduces muscle spasms and abdominal cramps. A jacuzzi, hot bath, hot water bottle, sauna or heating pads are easy ways to apply heat to the abdomen.

Complications from Irritable Bowel Syndrom

If left untreated, some cases of Irritable Bowel Syndrome can cause additional problems. It is not uncommon for people with IBS to develop a secondary ailment, and often more than one. Some possible progressions of IBS and secondary conditions are:

Depression and anxiety are very common in individuals with IBS. An estimated three fourths of IBS sufferers experience a bout of anxiety at some point in their illness, with half developing long term General Anxiety Disorder. Antidepressants are the common treatment for this, but the physician needs to be sure that the medication will not cause the symptoms of IBS to worsen, which can often happen.

Diverticulosis is another possible condition that may develop in individuals with Irritable Bowel Syndrome. A recent study showed that 19% of women with IBS and 9% of men were diagnosed with this condition. In diverticulosis, small pouches develop inside of the large intestine. They form due to ongoing pressure in the intestines, where fecal matter presses against weak areas of the intestines. These areas can eventually become infected and inflamed, however, that only occurs in 20% of cases.

Acne can often materialize due to digestive issues. If food is not properly assimilated and waste products build up in the bowels and blood stream, are emitted that try to escape through the skin. When individuals successfully treat bowel and digestive irregularity, they often see a drastic improvement in their skin.

Miscarriage and eptopic pregnancy can result from long term Irritable Bowel Syndrome. A study showed that 6.6% of women with IBS experienced spontaneous miscarriage, with another .74 percent experiencing an eptopic pregnancy. Researchers are still unclear as to exactly why IBS affects pregnancy and additional research will need to be done.

Insomnia or restless sleeping patterns can also be present in those with Irritable Bowel Syndrome. Often, the symptoms of the disease cause one to be in constant pain or need to use the bathroom frequently due to diarrhea, etc. Because of this, consistent, restful sleep patterns may be elusive.

Social Anxiety may also present itself in those with IBS. Due to the nature of the illness, many sufferers are self conscious about what are often uncontrollable body spasms that result in bloating, flatulence and a need to frequently eliminate. Because of the sensitive nature of IBS, many sufferers are uncomfortable in social situations or in taking long trips without ready access to a bathroom. This may hinder their ability to socialize normally with family and friends, attend work functions and travel.

Recent research shows that women with irritable bowel syndrome are at a higher risk of miscarriages and ectopic pregnancies. Ectopic pregnancies are abnormal pregnancies that develop outside of the uterus. Women in general have 25 percent chance of suffering a miscarriage. Only one out of 100 women have an ectopic pregnancy. The statistical difference of miscarriage and ectopic pregnancies between women with and without irritable bowel syndrome is small but measurable.

Prevention of Irritable Bowel Syndrom

The symptoms of Irritable bowel syndrome can be reduced or prevented by incorporating diet and lifestyle changes such as the following:

• Greatly increase your water intake
• Eliminate irritating foods such as refined sugar, gluten, coffee and alcohol, and milk can help to prevent symptoms.
• Carefully monitor the body after taking antibiotics and supplement with probiotics to repopulate the colon with health bacteria.
• Maintain a moderate exercise regimen, which will help to expel waste naturally and prevent constipation.
• Add plenty of fiber to the diet in the form of dark leafy greens, psyllium husks, flax seed and other healthy sources of roughage.
• Eat smaller, more easily digestible portions.
• Try to reduce sources of stress and seek treatment for uncontrolled anxiety, as these are contributors to IBS.
• Practicing Meditation or other mind/body technique to calm the nervous system.

References

EmedicineHealth.com: Irritable Bowel Syndrome (irritable bowel syndrome)
http://www.emedicinehealth.com/irritable_bowel_syndrome/article_em.htm

FamilyDoctor.org: Irritable Bowel Syndrome Overview
http://familydoctor.org/familydoctor/en/diseases-conditions/irritable-bowel-syndrome.html

IrishTimes.com: Irritable Bowel Syndrome May Increase Risk of Miscarriage
http://www.irishtimes.com/newspaper/health/2012/0410/1224314560778.html

Mayo Clinic: Irritable Bowel Syndrome
http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106

MedicineNet.com: Irritable Bowel Syndrome (irritable bowel syndrome)
http://www.medicinenet.com/irritable_bowel_syndrome/article.htm

MedicineNet.com: Natural Alternatives for irritable bowel syndrome
http://www.medicinenet.com/script/main/art.asp?articlekey=56855

National Digestive Diseases Information Clearinghouse: Irritable Bowel Syndrome
http://digestive.niddk.nih.gov/ddiseases/pubs/irritable bowel syndrome/

National Digestive Diseases Information Clearinghouse: What I Need to Know About Irritable Bowel Syndrome
http://digestive.niddk.nih.gov/ddiseases/pubs/irritable bowel syndrome_ez/#stress

http://nccam.nih.gov/health/homeopathy

New York Times: Malnutrition
http://health.nytimes.com/health/guides/disease/malnutrition/overview.html

Patient.Co.Uk: Irritable Bowel Syndrome
http://www.patient.co.uk/health/Irritable-Bowel-Syndrome.htm

PubMed Health: Ectopic Pregnancy
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001897/

PubMed Health: Irritable Bowel Syndrome
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001292/

University of Maryland Medical Center: Hypnotherapy
http://www.umm.edu/altmed/articles/hypnotherapy-000353.htm

University of Maryland Medical Center: Irritable Bowel Syndrome
http://www.umm.edu/altmed/articles/irritable-bowel-000098.htm

University of Maryland Medical Center: Melatonin
http://www.umm.edu/altmed/articles/melatonin-000315.htm

WebMD: Alternative Treatments for Irritable Bowel Syndrome (irritable bowel syndrome)
http://www.webmd.com/irritable bowel syndrome/alternative-therapies

WebMD: Dietary Fiber for Constipation

WebMD: Overview & Facts

WebMD: Slideshow: A Visual Guide to Understanding irritable bowel syndrome

Thirty to 50 percent of people develop insomnia at some point in their lives. Insomnia is a sleep disorder generally associated with a difficulty falling asleep or staying asleep, or both. Insomniacs have the time and opportunity to sleep, but still take 30 minutes or longer to fall asleep or sleep fewer than six hours a night. Around 10 percent of people may have chronic insomnia that prevents normal sleep for prolonged periods of time.

Types of Insomnia

Insomnia is categorized based on factors such as the cause or duration. There are three basic types of insomnia based on the length of time a person experiences sleep difficulties. Insomnia is sometimes broken down as short-term and long-term insomnia, but insomnia that is not long-term may actually be classified as either short-term insomnia or transient insomnia.

Transient Insomnia

Transient insomnia is a period of sleep difficulty that lasts a week or less. Some people consider transient insomnia part of short-term insomnia.

Short-Term Insomnia

Short-term insomnia is the appearance of insomnia symptoms that last for more than one week but less than three. Short-term insomnia is also called acute insomnia. Stress is the main reason behind symptoms of short-term insomnia, including transient.

Long-Term Insomnia

Long-term insomnia is when insomnia symptoms remain for longer than three weeks. This type of insomnia is also called chronic insomnia. The causes behind long-term insomnia are usually different than insomnia that lasts for a shorter duration.

Sleeping difficulty does not happen every night for someone to have insomnia. Even if a person only has difficultly falling or staying asleep three nights out of seven they are still said to have insomnia for that week.

Primary Insomnia

Insomnia may also be categorized as either primary or secondary insomnia. Primary insomnia is when people have difficulty sleeping that is not due to another health problem. It is also called psychophysiological insomnia. Frequently, people with this kind of insomnia cannot turn their minds off when they try to sleep; their minds race and they cannot relax.

Secondary Insomnia

Secondary insomnia is when people have a direct cause, such as a health condition, that leads to insomnia. A physical or mental health problem, or certain medications, could be behind secondary insomnia.

Childhood Onset Insomnia

Approximately 1 percent of people develop a difficultly falling asleep or staying asleep during childhood. They usually experience daytime sleepiness as well. This condition is called childhood onset insomnia. When young adults do not grow out of the insomnia and keep it for life the condition is called life-long insomnia. Childhood onset insomnia may be hereditary.

Subjective Insomnia

Some people have what is called subjective insomnia, which is when they sleep normally but think that they have insomnia. It is also known as paradoxical insomnia or sleep state misconception. Despite getting a full night’s sleep, people with this condition may end up at a sleep center complaining of insomnia only to discover after being observed all night that they slept undisturbed.

Learned Insomnia

Some people become insomniacs due to poor sleeping habits and worrying about sleep. These people try too hard to fall asleep or are kept awake because they worry about being able to sleep. Often this condition goes away when someone changes their environment because this removes the stimuli that prompted the sleep difficulties. Other people with learned insomnia can find themselves unaffected when they give up trying to sleep, such as when they fall asleep during a movie.

Idiopathic Insomnia

Idiopathic insomnia is when there is no obvious cause of the insomnia symptoms.

Insomnia Causes

There is no single cause of insomnia. The possible reasons for this condition are extensive. Physical, mental and emotional issues may all contribute to insomnia. Taking certain medications, experiencing certain life conditions and even having poor sleeping habits can all play a role in insomnia development.

Stress

Stress is one of the main causes of insomnia, particularly short-term insomnia. Insomnia may result from stress linked to specific events or can result from ordinary stresses of daily living. A traumatic or challenging event that could cause insomnia include:

• Death of a loved one
• Divorce
• Separation
• Being laid off or fired
• Studying for an exam or presentation

Short-term insomnia may also result from worrying about normal life concerns. A person’s mind may be unable to shut off because of concerns regarding health, family, school, work or other responsibilities.

Anxiety and Depression

Although several mental disorders may cause problems sleeping, anxiety and depression are two of the most frequent causes of insomnia, especially long-term insomnia. Anxiety disorders or simply feeling anxious about aspects of daily living can both lead to insomnia.

People who are depressed frequently experience difficulty sleeping or tend to sleep more than is healthy. Depression may stem from worrying or be the result of chemical imbalances in the brain that interfere with sleep.

The feelings of anxiety or depression may get worse the longer someone has insomnia because they become more sleep deprived. Increased anxiety or depression may make sleeping even more difficult.

Drugs and Stimulants

Certain substances may be at the root of some people’s insomnia. Both prescription medications, such as heart or allergy medications, and over-the-counter drugs from pain killers to decongestants may all interfere with natural sleep. Stimulants in foods and drugs are also potential causes of insomnia.

Medications that may cause sleep problems include:

• Allergy medications
• Antidepressants
• Blood pressure medication
• Cold and flu medicines
• Corticosteroids
• Decongestants
•  Diuretics
• Dopamine agonists
• Heart medications
• Niacin
• Oral contraceptives
• Pain killers
• Quinolone antibiotics
• Stimulants
• Thyroid hormones
• Weight-loss products, including appetite suppressants

Medications can contribute to insomnia because of how they affect the body while treating specific conditions. For example, dopamine agonists activate receptors for the hormone dopamine, which can promote wakefulness even in people who are sleep deprived. Some medications for Parkinson’s disease are dopamine agonists because the brains of people with Parkinson’s usually lack this hormone.

Some medications or supplements contain ingredients that interfere with sleep. Some pain killers and weight-loss products contain stimulants like caffeine. Cold and flu medications may have alcohol.

Medications like antihistamines can indirectly contribute to sleep problems. These drugs can make people tired and make urinary problems worse, which then causes people to wake up at night to urinate.

Some foods and beverages also have stimulants. Sodas, tea and coffee are typically high in caffeine. Energy drinks or other caffeine-containing products taken in the late afternoon may lead to insomnia.

Alcoholic beverages can cause people to be drowsy and fall asleep more easily, but alcohol interferes with the body’s ability to enter deep sleep states. These deep states are necessary for people to wake up feeling restful. Sometimes, alcohol makes people wake up in the middle of the night.

Withdrawal from alcohol can also cause insomnia. Even smoking cigarettes can cause insomnia in some people.

Conditions

There are many conditions that may cause insomnia. Some of these conditions may be medical issues that can make it difficult to sleep, such as breathing problems or post-traumatic stress disorder. Other causes can instead be a temporary condition that affects sleep cycles, like jet lag.

Physical

The human brain has an internal clock. Within the brain are two areas responsible for alerting the rest of the brain that is is time to sleep. These include the hypothalamus and brain stem. The hypothalamus and brain stem in someone with insomnia may be overactive and interfere with the ability to sleep.

Medical conditions that can cause insomnia include:

• Acid reflux
• Alzheimer’s disease
• Arthritis
• Breathing difficulties, such as asthma
• Cancer
• Chronic pain
• Chronic obstructive pulmonary disease
• Congestive heart failure
• Dementia
• Fever
• Fibromylagia
• Frequent or excessive urination
• Gastroesophageal reflux disease
• Hyperthyroidism
• Kidney disease
• Lung disease
• Obesity
• Parkinson’s disease
• Pregnancy
• Stroke
• Urinary incontinence

Many of these conditions cause pain or discomfort that make sleeping difficult. Pain killers or medications may lessen symptoms and subsequently help improve sleep.

Mental and Emotional

Depression, anxiety and stress frequently manifest as sleep problems. Insomnia may also result from other psychological or psychiatric issues, such as:

• Bipolar disorder
• Chronic stress
• Mania
• Menopause
• Menstrual cycle
• Post-traumatic stress disorder
• Psychosis

Women are particularly vulnerable to psychiatric based causes of insomnia. Hormonal shifts often occur during pregnancy, menopause or due to the menstrual cycle. Menopause symptoms like hot flashes can also cause insomnia because of the associated discomfort.

Sleep Disorders

A specific sleep disorder is frequently behind episodes of insomnia. Related sleep disorders include:

• Narcolepsy
• Obstructive sleep apnea
• Periodic limb movement disorder
• Restless leg syndrome
• Sleep walking

Environmental Reasons

A person’s environment affects their ability to sleep. Moving or trying to sleep in a new place, like a hotel room, can make it difficult to sleep well. Getting a new work schedule or changing timezones affects the circadian rhythms that are people’s internal clocks. These changes then affect the sleep-wake cycle. Physical discomfort and certain sensations may disrupt sleep too. Sleep disrupting stimuli  include:

• Cold
• Heat
• Lights
• Noises
• Partner snoring or moving around
• Uncomfortable mattress
• Unpleasant smells

Usually, if these unpleasant stimuli are taken away people are able to sleep well again. Sometimes, people can adapt to these disturbances and resolve their insomnia that way.

Poor Sleep Hygiene

Sleep hygiene refers to habits that lead to restful sleep. A person with bad sleep habits is said to have poor sleep hygiene. Insomnia can easily result from poor hygiene. Changing sleep habits can therefore resolve insomnia.

Beds should be used for sleeping and sexual activities, nothing else. Reading, eating, working, watching TV, talking on the phone or engaging in any other stimulating activity in bed interferes with the mind’s ability to quiet down and recognize that going to bed means it is time to sleep. Even lying in bed thinking can make it difficult to fall asleep that night and in the future.

Taking naps during the day and going to bed or waking up at different times are also bad sleep habits. Exercising near bedtime may inhibit sleep. Eating dinner or a large snack close to bedtime can also cause sleep difficulties. A small snack usually does not cause problems, but eating anything that may lead to heartburn can keep people awake. On the other hand, trying to sleep while someone is hungry is difficult too.

Age-Related Insomnia Causes

The internal clock setting that controls the sleep cycle is different for all stages of life. Moving into a different life phase affects the internal clock and can lead to insomnia, especially when a person does not change their lifestyle to match their new phase.

It is common for older people to be more sedentary, develop more health problems and to be affected more by environmental issues like noise or temperature changes. Reduced physical activity may contribute to insomnia.

Older people are more likely to have health conditions that make sleeping hard, such as painful arthritis or back problems. These types of problems may make falling asleep difficult due to discomfort, as well as affect the quality of sleep.

Seniors are also more at risk for developing sleep disorders, including sleep apnea and restless leg syndrome. Both of these conditions may cause people to wake up frequently.

With more health problems often comes increased dependency on medications, including medications known to cause or contribute to insomnia. Also, many older people naturally wake up earlier and feel less rested after sleeping.

Children and teenagers may have their own issues with sleep. Many teenagers are natural night owls. Some children are too. Their bodies are unable to fall asleep before 11PM or later because their internal clocks say it is not time to sleep until late at night. It is also natural for these children and teens to naturally want to wake up later.

Unfortunately, many school systems are set to accommodate the sleep schedules of adults, not the delayed internal clocks of the larger population of young people who attend school. This scheduling may lead to insomnia among teenagers and younger children.

Short-Term Vs. Long-Term Causes

Certain causes of insomnia are more likely to be associated with short-term or long-term insomnia. Short-term is more likely to be linked to:

• Changing jobs or shifts
• Environmental factors, such as loud noises or extreme temperatures
• Events, such as divorce or losing a job
• Jet lag
• Illness
• Physical discomfort
• Temporary medications, such as allergy or cold meds

Long-term causes are more likely to be associated with underlying conditions or long-term issues, such as:

• Anxiety
• Chronic pain or stress
• Conditions that cause discomfort during the night
• Depression
• Medications
• Sleep disorders
• Substance abuse

Symptoms of Insomnia

Insomnia causes many symptoms besides waking up often at night or taking a long time to fall asleep. Insomnia affects mood and sleep disturbances, leading to symptoms that include:

•  Anxiety
• Daytime sleepiness
• Depression
• Difficulty concentrating
• Difficulty falling asleep
• Fatigue
• Frequent thoughts of worry related to sleep
• Headaches
• Increased frequency or mistakes
• Irritability
• Gastrointestinal problems, such as upset stomach
• Low energy
• Mood changes
• Not feeling rested after a full night’s sleep
• Poor memory
• Reduced ability to perform tasks
• Waking up throughout the night
• Waking up too early

Risk Factors

Certain populations and individuals are at a higher risk than others for insomnia. These include:

• Adults over 60 years of age
• Alcoholics
• Drug addicts
• Frequent travelers
• Menopausal women
• Night workers
• People with mental disorders
• Pregnant women
• Shift workers
• Young adults

Insomnia Tests and Diagnosis

Doctors use several methods and tests to diagnose insomnia. Diagnosis may be an exhaustive process, including a physical examination, discussion about sleep history and a complete review of medical history and psychiatric history. In some cases, doctors have to refer patients to sleep centers.

Medical History

Generally, the diagnostic process for insomnia begins with a thorough evaluation of a patient’s medical and psychiatric history. Reviewing a patient’s history can pinpoint a condition that is causing the  insomnia.

When discussing medical histories, doctors may ask if patients are taking any medications, have any long-term medical conditions or are in any pain. A doctor may also evaluate a patient for signs of psychosis or mood disorders as well as determine the patient’s stress levels.

A patient’s day to day activities and details of their work and personal lives are also relevant. Part of a medical history may include determining a person’s level of physical activity, travel history, daily schedules and information about their work and personal lives.

Physical Exam

Physical exams are an important part of the diagnostic process. Current medical issues could account for insomnia. A physical exam may include blood tests, mental assessments, body measurements and organ function.

Blood tests are a simple part of a physical exam. A blood test can identify if someone has a condition like a thyroid problem that is associated with insomnia.

More extensive tests may be performed to evaluate the functioning of the lungs and heart. An ear, nose and throat examination is also part of the process as well as an abdominal exam. Doctors may take measurements at the neck and waist too.

Sleep History

Doctors usually ask their patients about their specific sleeping problems using a series of specific questions. They may use questionnaires to figure out how much their patients insomnia impacts daytime fatigue and their sleep-wake schedule. Questions doctors ask include:

• How long patients sleep
• When they fall asleep
• How long it takes to fall asleep
• How often they wake up
• How long they remain awake when they do wake up during the night
• What time they wake up in the morning
• How often they take naps during the day
• If they ever wake up with shortness of breath
• How rested a patient feels in the morning and throughout the day
• What a patient’s routine is before bed
• If a bedroom has potential sleep distractions, like a TV

Doctors may speak with a patient’s partner for further information regarding sleep history. Bed partners can give insight into whether patients move a lot in their sleep or if they snore.

A sleep diary is often a diagnostic tool. Doctors may advise their patients to write down information about their sleeping patterns in a diary for one to two weeks. Patients record their sleep quality, when they fall asleep, how often they wake up and what time they awaken each morning. Sleep diaries also record how patients feel during the day and if they have any difficulties with focusing on daily tasks. Other pertinent information includes consumption of stimulants like caffeine and medications.

Tests

Some patients may need to visit a sleep center where staff can perform less common tests and observe patients’ sleeping patterns. Sometimes patients are sent to sleep centers to confirm or rule out a suspected diagnosis, but other times doctors refer patients when they have no idea what could be causing the insomnia.

One diagnostic test sleep centers use is a polysomnograpy (PSG). This test is sometimes recommended if a person is suspected of having obstructive sleep apnea, a condition whereby someone stops breathing while asleep. A PSG involves hooking patients up to machines that monitor their breathing, heart rate, brain waves, eye movements, blood pressure, oxygen levels and chest movements. Observing a person’s chest movements and oxygen levels gives information that can confirm sleep apnea if a person ceases to breathe or is not taking in enough oxygen. Trained physicians, including lung specialists, evaluate the data to determine if sleep apnea is present.

Another test that sleep center specialists may use is an actigraphy. Like a PSG, this test is not routine but is ordered under certain circumstances. Most often, an actigraphy is performed to ascertain whether someone has a circadian rhythm disorder, is suffering from subjective insomnia or has primary insomnia. An actigraphy involves wearing a device called an actigraph. This device is worn on the wrist. It records movement all the time, including when a patient is awake and sleeping. Actigraphs also have an on-board memory and microprocessor to record data.

Specialists may also evaluate daytime fatigue using a questionnaire called the Epworth Sleepiness Scale. Results may indicate insomnia or rule it out.

Sleep center specialists also consider any recent weight gain or chronic snoring when making a diagnosis.

Insomnia Treatment

Insomnia treatment covers a range of options because of the variety of causes. Transient insomnia usually goes away once the trigger is removed, but first the trigger needs to be identified. Treatment for insomnia that lasts longer must address the underlying cause. Simply addressing the symptoms does not actually treat insomnia, but treating the underlying problem may cause insomnia symptoms to disappear.

Treatment programs typically include both medical and non-medical treatments. Combining these two aspects usually is more successful than just one type. Non-medical treatments include therapies such as sleep restriction, sleep hygiene, relaxation therapy and other behavioral therapies.

Sleep Hygiene

Sleep hygiene is one of the main behavioral therapy treatments. Adopting healthy sleeping habits may be enough to cure insomnia in some people. Some potentially beneficial sleep hygiene modifications include:

• Engaging in consistent physical activity for a minimum of 20 minutes per day
• Working out more than four hours before bedtime
• Avoiding sleeping too much
• Creating an ideal sleep environment, such as setting a comfortable room temperature and blocking out light
• Following a set sleep schedule every day
• Avoiding caffeinated products in the afternoon and at night
• Avoiding alcoholic drinks before bedtime
• Quitting smoking
• Eating a large enough dinner or a light snack to avoid hunger at bedtime
• Dealing with stress or worries before bedtime
• Getting out of bed if one cannot fall asleep after 20 minutes
• Doing something relaxing before bed, such as a warm bath, yoga or deep breathing exercises
• Performing all activities other than sleep or sexual activities somewhere other than the bed
• Limiting naps to at most 30 minutes in duration
• Napping before 3 PM
• Removing distracting items like computers and TVs from the bedrooms
• Drinking or eating less before bedtime to avoid frequent urination or digestion issues
• Hiding clocks in the bedroom
• Wearing earplugs or creating white noise with a fan or sound machine
• Making a to-do list before bedtime to decrease worrying

Relaxation Therapy

Relaxation therapy is another non-medical treatment method for insomnia. The goal of relaxation therapy is teaching people how to regulate their mood, breathing, heart rate and tension levels. Muscle tension may be just as troublesome for sleeping as a mind that cannot shut down.

Some types of relaxation therapy include:

• Biofeedback
• Breathing exercises
• Dimming the lights up to an hour before bedtime
• Progressive muscle relaxation
• Soothing music before bedtime

Individuals may find different activities relaxing so it is important to tailor relaxation therapy based on how a person responds. It may take individuals a few weeks to learn the relaxation therapy techniques well enough to reduce insomnia.

Stimulus Control Therapy

Stimulus control therapy is a treatment for long-term insomnia. It involves following simple steps to promote healthy sleep, such as:

• Exposing oneself to natural sunlight daily
• Going to bed when a person feels sleepy
• Practicing good sleep hygiene
• Taking short naps in a darkened room every afternoon

Sleep Restriction Therapy

Sleep restriction therapy is a method for improving sleep quality by restricting time spent in bed. This therapy is dependent upon following a strict regimen of waking up at the same time each morning and going to bed at the same time. It actually begins by creating sleep deprivation by letting people spend little time in bed. Even if someone is tired when they awake at their set time, that person must get up.

The main idea is that someone will be better able to fall asleep eventually if they are forced to spend little time in bed. As a person’s sleep quality improves, their time spent in bed is gradually increases.

Sleep restriction also works to improve sleep quality by following specific guidelines. Sleep restriction advises patients to:

• Avoid drinking large amounts of fluid before bed
• Avoid eating large meals before bed
• Control the bedroom environment
• Conduct business or stressful activities somewhere other than the bedroom
• Follow sleep hygiene guidelines and use relaxation therapy

A central component of sleep restriction therapy is controlling lighting because the circadian rhythms that regulate sleep are extremely light sensitive. People who work nights or who need to sleep during the day for other reasons may need to block out light from their bedrooms with sleep shades. If they have children, they may need childcare services so their children cannot disturb their sleep.

Cognitive Behavioral Therapy

Some people’s insomnia may be caused by excessive worrying before bed. Cognitive behavioral therapy teaches people to replace their worries with positive thoughts. Therapists work with people individually or in group therapy.

Click here to view the embedded video.

Light Therapy

Light therapy can reprogram a person’s biological clock. People who wake up or fall asleep too early can use light therapy to adjust their circadian rhythms and improve sleep patterns. Going out into the sunlight in the early evening or using a medical-grade light box at night can help people stay up later. People can then awaken later and get onto a normal sleep schedule.

Insomnia Medications

Medications treat insomnia in some cases by treating underlying causes. Medications may also reduce insomnia symptoms.

Prescription Medications

Prescription sleeping pills make it easier for some people to fall asleep. These medications include:

Benzodiazepine Sedatives

• Clonazepam (Klonopin)
• Estazolam (ProSom)
• Flurazepam (Dalmane)
• Lorazepam(Ativan)
• Temazepam (Restoril)
• Triazolam (Halcion)

Nonbenzodiazepine Sedatives

• Eszopiclone (Lunesta)
• Zaleplon (Sonata)
• Zolpidem (Ambien)

Side Effects

Sleeping pills can cause side effects resulting from an allergic reaction. Side effects may include:

• Abnormal behavior
• Agitation
• Difficulty balancing
• Drowsiness
• Facial swelling
• Impaired thinking
• Night wandering

Instead of the above sedatives, doctors may prescribe L-trytophan (Tryptan) or ramelteon (Rozerem). Ramelteon stimulates melatonin receptors to help people fall asleep. L-tryptophan is both a naturally occurring amino acid and a medication.

L-tryptophan is an essential amino acid, which means that the body needs to get it from an outside source like food or supplements. L-tryptophan medications decrease sleep latency and help insomniacs fall asleep easier. The body converts L-trypotphan to 5-hydroxytryptophan, which is the precursor to serotonin, a chemical that induces sleep.

L-tryptophan was sold as a sleep aid in the United States until 1989, but is now available by prescription only. However, 5-hydroxytryptophan is currently available as an over-the-counter sleep aid. This supplement may also be beneficial for weight loss and depression.

L-tryptophan may cause side effects, including:

• Abdominal gas
• Abdominal pain
• Appetite loss
• Bloating
• Blurry vision
• Diarrhea
• Drowsiness
• Headache
• Heartburn
• Lightheadedness
• Nausea
• Sexual problems
• Weakness

Older people are more at risk for side effects from prescription pills than younger people. Some of these pills are habit-forming. A few sleeping pills are able to be used over the long-term, but most are only supposed to be used for a few weeks at a time.

Treatment is generally most successful when medications are combined with behavioral therapy, which eventually allows people to stop taking prescription sleep aids.

Over-The-Counter Sleeping Medications

Medications to improve sleep are also available without a prescription. Popular over-the-counter sleep medications include nonprescription antihistamines and melatonin.

Antihistamines

Antihistamines include medications like doxylamine and diphenhydramine (Benadryl). Antihistamines do produce a sedative effect, which allow may cause drowsiness. However, they actually reduce sleep quality. They may also cause side effects, such as:

• Blurry vision
• Daytime fatigue
• Dry mouth

Antihistamines should not be used for long-term insomnia because of the negative effect they have on sleep quality.

Melatonin

Many over-the-counter sleep aids contain a substance called melatonin. The pineal gland in the brain secretes melatonin when it is dark. By increasing melatonin levels, the brain tells the body that it is time to sleep.

Some people do not have normal amounts of melatonin and may benefit from taking melatonin supplements. Older adults may also be low in melatonin. A typical dosage of melatonin is between 0.3 and 5 milligrams daily.

Depression Medications

Some insomniacs are also depressed. These people may be prescribed antidepressants that have a sedative effect. Antidepressants include:

• Doxepin
• Mirtazapine
• Trazodone

Medical Therapies for Specific Conditions

Shift Changes

People with insomnia from working new shifts or varying shifts can treat insomnia with specific techniques. Some experts recommend taking sedatives for a few days after being assigned a new shift to adjust to the different sleep schedule. Naps to make up for lost sleep due to shift changes are also recommended by some, but not all, doctors.

Behavioral therapy is often useful for this type of insomnia. Sticking to firm bedtimes and waking up at the same time is especially important for shift workers, though the times change with the shift changes.

People who need to change shifts are least disturbed when shifts change in a forward direction, such as first working mornings and then starting a midday or afternoon shift. From working afternoons, people can then adapt to working evenings before they start working nights. Each of these shifts may require a week to adapt to the new work schedule.

Short-Term Insomnia from Stress

People who have insomnia because of stress may respond well to using a low-dose sedative on a short-term basis as they work to relieve their stress. Experts report that reassurance and support help to resolve many of the stressors that inhibit proper sleep. Learning good sleep hygiene is also beneficial.

Alternative Treatment

Alternative treatments from herbs to acupuncture are used to treat insomnia. Some people may be able to treat their insomnia without pharmaceuticals or professional help. However, people should still consult their doctors first in case they have a condition or are taking medications that contraindicate usage of certain alternative medicines.

Herbal Remedies for Insomnia

Many people use herbs for insomnia, with varying degrees of success. Some of the popular herbal remedies in the United States for insomnia include:

Valerian

Valerian root (Valeriana officinalis) is one of the most frequently used herbs taken for insomnia. It produces a mild sedative effect that can help people fall asleep and remain sleeping through the night. Valerian may be beneficial for long-term insomnia, but there have not been a lot of studies done to determine its effectiveness.

Valerian is one of the herbs approved by the German government for sale as a sleep remedy, along with hops and lemon balm. Valerian is approved for sale in the United States as a dietary supplement. A typical dosage of valerian is between 400 and 900 milligrams per day, which contains around 0.4 to 0.6 percent valerenic acid.

Chamomile

Chamomile is another popular herb for insomnia, although there is little evidence that is works. The U.S. Food and Drug Administration (FDA) states that chamomile is generally safe and has no side effects.

Passionflower

Passion flower (Passiflora incarnata) is commonly used for insomnia. In animal studies, passionflower has been shown to increase sleeping time though there are few human trials that show how well it works for insomnia. No side effects are known, though it is not recommended for pregnant women. A typical dosage for passionflower is between 4 and 8 grams.

Hops

Hops (Humulus lupulus) is a traditional medicine for sleep difficulties as well as intestinal problems. Hops has a sedative effect and is an approved sleep aid in Germany. For insomnia treatment, hops may be mixed into a tea or in capsule form. A standard dose is 0.5 grams. Hops is contraindicated for pregnant women and women with certain breast cancer.

Diet

Diet can have a positive impact on insomnia. Magnesium in particular may play an important role in preventing sleep difficulties. Women seem to be more at risk for insomnia when their estrogren levels are low, such as during menopause. Soft tissues need estrogen to uptake magnesium; therefore, lower than normal levels of estrogen may result in less than optimal levels of the mineral in the body.

Magnesium helps muscles to relax. It also stops the fight or flight response, which is a process the body goes through when it perceives a threat. The flight or flight response releases hormones that make people alert and increase energy in case there is a need to run away or fight off an attacker. These hormones are counterproductive to sleep.

Magnesium deficiencies may also make some conditions worse, including anxiety, heart failure, restless leg syndrome, PMS, migraines and fibromyalgia, all causes of insomnia.

A diet that is high in magnesium and low in aluminum is linked with good quality sleep and low instances of waking up at night. Aluminum is present in water and food additives, as well as some herbs and teas in low amounts. Foods that have been cooked or stored in aluminum containers or using aluminum utensils contain higher aluminum levels and may need to be avoided if on a low aluminum diet.

Eating foods rich in magnesium along with taking magnesium supplements increases magnesium levels. Foods rich in magnesium include:

• Tofu
• Bran cereal
• Legumes
• Bananas
• Green leafy vegetables
• Almonds
• Cashews
• Molasses
• Pistachio nuts
• Chocolate
• Oat flour
• Squash
• Pumpkin
• Wheat bran
• Whole grains

Although whole wheat is a source of magnesium, eating whole grain products may contribute to insomnia in some people.

Magnesium deficiency changes brain waves, which can lead to waking up frequently, low quality sleep and other sleep disturbances. Symptoms of a magnesium deficiency include:

• Agitation
• Anxiety
• Irregular heart beat
• Irritability
• Insomnia
• Low blood pressure
• Mental confusion
• Muscle spasms
• Nausea
• Restless leg syndrome
• Seizures
• Weakness

Alternative Therapy Considerations

Alternative therapies are not approved by the FDA. Not all “natural” cures are safe. Some supplements can interact with medications or contribute to other issues. Some general guidelines for using alternative therapies safely are:

• Avoid supplementary blends containing more than one herb
• Choose products that list important information on their labels, such as an expiration date, manufacture’s name and address, side effects and a batch and lot number
• Consult a doctor before using alternative therapy
• Do not believe manufacture claims, especially over clinical study results
• Stop taking herbal supplements if there are any side effects, such as anxiety, rash, diarrhea or nausea

Complications

Insomnia causes direct symptoms like daytime fatigue, yet it can also lead to serious complications. Lack of sleep may not only make people feel tired during the day, it may also lead to car accidents, falls and severe difficultly performing their usual routines.

Nearly 20 percent of automotive accidents are caused by drivers who are sleepy. Insomnia is likely behind some of these accidents. Not enough sleep slows reaction time as well.

Insomnia also increases the risk of falls for older women. Older women are a high risk group for bone loss and even osteoporosis, which makes falling a serious problem as falls can easily lead to bone fractures when the bones are weak.

People who do not get enough restful sleep say that it lowers their quality of life.

Insomnia may contribute to other health problems. It can contribute to becoming overweight or obese, which is a risk factor for serious conditions like heart disease. It also may lead to psychiatric problems like an anxiety disorder.

Lack of sleep leads to poor immune system function, leaving people open to issues like catching viral infections. Insomnia also can worsen long-term conditions and increase risk of diseases like diabetes and high blood pressure.

Prevention

People can frequently prevent insomnia by adopting correct sleeping habits and learning to relax. Refraining from engaging in any activities other than sleep or sex in the bed and following a set sleep schedule even on their days off help most people sleep better. Other guidelines include:

• Avoiding vigorous exercise prior to bedtime
• Controlling the environment, including temperature, light and noise
• Getting out of bed after 20 minutes instead of lying in bed awake
• Limiting naps to 15 minutes or less
• Refraining from eating large meals, drinking a lot of fluids or using stimulants like nicotine and caffeine before bedtime

References

Alternative Medicine Review. Treatment of Insomnia – An Alternative Approach:

http://www.thorne.com/altmedrev/.fulltext/5/3/249.pdf

Centers for Disease Control and Prevention. How Much Physical Activity Do Adults Need:

http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html

CTDS.info. Natural Health. Tips for Insomnia:

http://www.ctds.info/insomnia_treatment.html

DrWeil.com. 10 Natural Sleep Tips:

http://www.drweil.com/drw/u/ART02037/sleep-aid

EMedTV. Skullcap:

http://insomnia.emedtv.com/skullcap/skullcap.html

EMedTV. St. John’s Wort and Insomnia:

EMedicine Health. Insomnia:

http://www.emedicinehealth.com/insomnia/article_em.htm

HelpGuide.org. Can’t Sleep:

http://www.helpguide.org/life/insomnia_treatment.htm

Maharishi University of Management.

http://www.mum.edu/cbcc/categories.html

Mayo Clinic. Insomnia: Are All Meditation Techniques the Same:

http://www.mayoclinic.com/health/insomnia/DS00187

Mayo Clinic. Magnesium Supplement (Oral Route, Parenteral Route):

http://www.mayoclinic.com/health/drug-information/DR602371

MedicineNet.com. Insomnia

http://www.medicinenet.com/insomnia/article.htm

Medill Reports. Brain Music: Turn On, Tune In, Feel Better:

http://news.medill.northwestern.edu/chicago/news.aspx?id=159319

National Heart Lung and Blood Institute: What Is Insomnia:

http://www.nhlbi.nih.gov/health/health-topics/topics/inso/

Oprah.com: The Sounds of Sleepiness:

http://www.oprah.com/health/Insomnia-Cure-Brain-Music-Therapy

Psychology Today. St. John’s Wort — Perk Up Your Tea

PubMed.gov. Dietary and Other Sources of Aluminum Intake:

http://www.ncbi.nlm.nih.gov/pubmed/1490425

Science Daily. One Sleepless Night Increases Dopamine In The Human Brain:

http://www.sciencedaily.com/releases/2008/08/080819213033.htm

Sleep. Effects  of  Low Energy Emission Therapy in Chronic Psychophysiological Insomnia:

http://www.journalsleep.org/Articles/190410.pdf

The Daily Heal. The Different Types of Meditation Techniques:

http://dailyheal.com/meditation-techniques/

University of Maryland Medical Center. Jamaica Dogwood:

http://www.umm.edu/altmed/articles/jamaica-dogwood-000258.htm

University of Maryland Medical Center. Lemon Balm:

http://www.umm.edu/altmed/articles/lemon-balm-000261.htm

University of Maryland Medical Center. Magnesium:

http://www.umm.edu/altmed/articles/magnesium-000313.htm

US News. Insomnia:

http://health.usnews.com/health-conditions/sleep/insomnia

WebMD. Alternative Treatments for Insomnia

http://www.webmd.com/sleep-disorders/guide/alternative_treatments_for_insomnia

WebMD. An Overview of Insomnia:

http://www.webmd.com/sleep-disorders/guide/insomnia-symptoms-and-causes

WebMD. L-Tryptophan

Integrative Medicine and Its Rapid Growth

A nationwide study which was conducted and published in 1993 brought Integrative Medicine to the forefront with the findings which confirmed that as many as one in every three Americans have used an alternative therapy of one kind or another. The two out of three Americans who until then had not yet used alternative therapy finally became aware of its existence and many proceeded to give it a try. Hospitals, clinics and medical centers took these findings to heart and the last ten or so years have seen many medical institutions espousing the Integrative Medicine into their otherwise conservative practice. According to the American Hospital Association, the number of hospitals that offer complementary therapies in the United States is in an extraordinarily rapid growth pattern as only 8.6 percent of hospitals offered it in 1998 in comparison to over 50 percent of hospitals offering it in 2008.

In spite of the fact that most complementary treatments are not covered by insurance and some are not inexpensive, Integrative Medicine has tremendous appeal as it seems to provide patients and professionals more time, more attention, more focus and a broader and farther reaching approach to healing as wisdom is drawn from a variety of cultures. In addition, the professionals see better results reached quicker while patients feel like whole human beings with a complete identity rather than a mere ailment.

The Osher Center for Integrative Medicine at the University of California in San Francisco takes a wide-ranging perspective on health and disease as its website states, “Integrative medicine seeks to incorporate treatment options from conventional and alternative approaches, taking into account not only physical symptoms, but also psychological, social and spiritual aspects of health and illness.” In an effort to advance and promote Integrative Medicine throughout the nation, the Osher Center and thirty other university medical centers including Duke, Harvard, Columbia, Georgetown and Penn formed the Consortium of Academic Health Centers for Integrative Medicine.

Opponents Drive Research into More Action

Just as there are many proponents for Integrative Medicine, there are also many opponents who claim that there is simply not enough hard scientific evidence to prove that any of the alternative or complementary approaches indeed have any true or lasting effects on patients who are dealing with real medical issues. Opponents are concerned that too many resources are spent on a mere fad that has no more healing power than a placebo. The demands for more proof and the ever present quest to uncover mysteries propelled researchers into a frenzy of actions in search for more answers about alternative medicine — and the hunt is still ongoing.

Scientists hypothesize that high plasma levels of insulin and glucose which stem from Insulin Resistance are the origins of the Metabolic Syndrome and Type 2 Diabetes (Diabetes Mellitus) and their various complications. It was Professor Wilhelm Falta (Vienna, 1931) who first introduced the concept and Sir Harold Percival Himsworth of the University College Hospital Medical Center in London confirmed it in 1936.

Symptoms of Insulin Resistance

The symptoms of Insulin Resistance vary greatly due to the overall health of the person, the age, as well as the person’s lifestyle and gender. The most commonly occurring, however, are:

• High blood sugar.
• Increased blood triglyceride levels.
• Elevated blood pressure (hypertension).
• Bloated intestines due to increased gas which is produced from ingesting carbohydrates.
• Low physical energy and overall body fatigue.
• Impaired concentration and diminished ability to focus. This may also be considered as mental weariness.
• The unbalanced metabolic process often leads to psychological effects such as depression and anxiety.
• Sleepiness soon after eating a meal that contains more than 20 or 30 percent carbohydrates.
• Fat storage around the abdominal organs in men and women alike. This, therefore, leads to weight gain and the difficulty in losing it.

The Origins of Insulin Resistance

The origins and causes of Insulin Resistance have not been conclusively determined but there is some undeniable and fundamental evidence which points to several culprits:

• Heredity. The most often pronounced suspected culprit would be heredity as more families have been observe whose close members have been diagnosed with Type 2 Diabetes that resulted from Insulin Resistance while other families had no members with such afflictions.
• Carbohydrates. There is strong evidence that lays the blame on high carbohydrate diets.
• Glucosamine. Glucosamine is an amino sugar that is often prescribed for a variety of problems related to joints and some studies have blamed it for triggering Insulin Resistance in some individuals.
• Polycystic Ovary Syndrome (PCOS). This is an endocrine disorder which occurs in approximately five percent of all women. It has been closely associated with Insulin Resistance but it is unclear whether Polycystic Ovary Syndrome leads to Insulin Resistance or, conversely, that Insulin Resistance leads to Polycystic Ovary Syndrome.
• Fructose and Sucrose. Studies have shown that the increased fructose and sucrose in today’s diets, particularly in the Western world, are in direct proportion to the rise in diagnosed cases of Insulin Resistance and Type 2 Diabetes. It then becomes reasonable to assume that diets rich in fructose and/or sucrose may lead to Insulin Resistance.
• Obesity. Morbidly overweight people seem to be more prone to Insulin Resistance.

Treatment for Insulin Resistance

The most effective and most frequently prescribed treatment for Insulin Resistance is exercise, weight loss and a lowered carbohydrate diet.

• There are 900 thousand known species of insects in the world. This makes them the most diverse group of organisms with a number of species greater than any other group.
• It is estimated that there are still as many as 30 million species of insects that have not yet been identified and named by scientists.
• Entomologists have estimated that there are 10 quintillion (10,000,000,000,000,000,000) individual insects living among us at any given time.
• In the United States alone, the estimated known species are 91,000 while the unknown are estimated at 73,000. The largest counts of known species are categorized into four major groups: Coleoptera (beetles) with 23,700, Diptera (flies) with 19,600, Homenoptera (ants, bees, wasps) with 17,500 and Lepidoptera (moths and butterflies) with 11,500.
• There are more than 200 million insects for every human being on earth and an article in a recent New York Times publication claimed that there are 300 pounds of insects for every pound of humans on planet earth.
• Their vast numbers, according to scientists, are largely due to their exceptionally long geological history, their capability of flight, their small sizes allow them to create habitats just about anywhere, their ability to hoard sperm for postponed fertilization and their immense fertility, as well as their ability to adapt to the ever-changing environment.

Insect Bites Allergic Reactions

It is said that insects do not attack unless they are provoked. However, due to the size disparity, the most innocent movement we make may be viewed as aggressive and threatening to an insect that is smaller than the tiny nail on our smallest finger. So, we get stung or bitten by defensive little beings. Many of the stings and bites go unnoticed but some result in a localized redness and swelling which may or may not be accompanied by itching and pain. Other bites or stings can be life-threatening to people who get an allergic reaction to the venom that was injected at the time of the insect’s attack.

Bees, wasps, hornets, yellow jackets and fire ants are insects whose attacks most frequently cause serious allergic reaction. As a matter of fact, death from bee stings is three to four times more prevalent than death from snake bites.

Certain insect bites or stings may lead to a wide variety of disease ranging from the insignificant to the very serious:

• Mosquitoes do not usually cause serious problems unless they carry organisms such as those leading to Malaria, the West Nile Virus, Encephalitis, Dengue and Yellow Fever.
• Lice can communicate Epidemic Relapsing Fever or Typhus.
• Sand flies can transmit Leishmaniasis.
• Tsetse flies pass on the Sleeping Sickness.
• Deer flies can spread Tularemia.
• Fleas can spread the Bubonic Plague.
• Ticks spread Lyme Disease.
• Chiggers and mites usually only leave local swelling and itching.

Symptoms of Insect Bites or Stings

• Pain, swelling redness and itching of the affected area. An infection may set in if the area is scratched.
• If the bite or the sting triggers an allergic reaction, the symptoms are more serious and may lead to anaphylaxis (anaphylactic shock) whose symptoms begin with hives, and then progress to wheezing, shortness of breath, loss of consciousness and even death within thirty minutes.
• If the tongue is stung or bitten by an insect, the throat may swell and close off the airway passages.
• Stings from large hornets or multiple bee stings have been known to cause muscles to breakdown and the kidneys to shut down.

Treating Insect Bites and Stings

All insect bites should be tended to as soon as possible by cleansing the affected area, removing the sting if it was left visibly, and applying ice to reduce the swelling as well as administering an antihistamine (topical plus oral) to relieve the itching. Any insect bites or stings which results in symptoms that are more severe than the mere localized itching and redness, should be immediately seen by a medical professional.

Preventive medicine is always preferable and insect bite or stings can be avoided by applying insect repellants, especially when participating in outdoor activities.

Home-Based Treatments For Ingrown Toenails

If they are recognized at an early stage and before infection sets in, Ingrown Toenails can effectively be treated at home:

1/ Bathe the affected toe in water that is as hot as can be tolerated three or four times a day.
2/ Between bathes, keep the affected toe completely dry.
3/ Wear open-toe shoes or sandals until the Ingrown Toenail has been cured. Closed shoes may be worn but they must be very roomy.
4/ If the pain is too severe, take ibuprofen or acetaminophen to relieve it.
5/ There should be an apparent improvement of the condition within two or three day. If, however, the Ingrown Toenail shows no improvement or even seems to have gotten worse, professional medical advice must be sought right away.

Professional Medical Treatments For Ingrown Toenails

If and when all of the home-based treatments failed and the Ingrown Toenails has become more inflamed, the swelling has spread, the pain is more severe and there is an oozing discharge, the site is now infected. The medical professional may do one or all of the following:

• Prescribe antibiotic medications for oral ingestion as well as an antibiotic topical.
• Surgery to remove part of the nail (partial nail avulsion), the entire nail (complete nail plate avulsion) and/or some of the surrounding soft tissue may be the next step of treatment process.
• It may take up to three or four months for the toenail to re-grow completely and in that time period the toe must be closely guarded from injury and kept very clean and dry to avoid an infection.

Possible Complications

If the Ingrown Toenail goes unnoticed or the condition is simply ignored, the localized infection may spread into the local bone and beyond, which makes the condition a whole lot more serious. In diabetic patients whose blood circulation and nerve supply to the feet have been significantly curtailed, an untreated Ingrown Toenail may result in hard-to-treat open sores or foot ulcers which are likely cured by surgical removal. If and when foot ulcers are left untreated they can eventually become gangrenous and in extreme situation may require amputation as the only means by which to stop the dire condition from further spreading.

Be good to your toes and pay close attention to their needs.

How To Treat Ingrown Hairs

Here are some options, but it is up to you to decide which works best for you and your particular anatomical site of ingrown hair:

1/ If possible, shave less frequently to let the hair grow out and to allow the affected area to heal. If letting your hair grow is not an option:

- Use a single blade razor and avoid pressing too hard.
- Stretch the skin and follow the direction of the growth (face downwards, neck upwards, legs upwards, bikini area sideways, armpits downward).
- Use the same blade only two or three times.
- Shave only after having thoroughly soaked the area with plenty of hot water and always use shaving cream.
- Cologne may add to the irritation but a medicated after shave lotion is a good idea.

2/ Gently lift out the ingrown hair with a cleansed pinpoint and let it heal.

3/ Using the sharp point of a cleansed pair of tweezers, you may pluck the ingrown hair out.

4/ Exfoliate the dead skin cells which are trapping the ingrown hair by rubbing your face with a loofah sponge, a soft skin brush or any number of cosmetic scrubs and/or exfoliating masks.

5/ The various acne skin products available on drugstore shelves work effectively to relieve and heal the irritated areas.

6/ When the red bumps become infected they fill with pus and a dermatologist should assess the condition at this point. Try to resist the temptation to squeeze it because that can only lead to other unpleasant skin conditions.

7/ Electrolysis and laser hair removal kill the roots of hair to prevent them from ever growing back again. These may be good solutions for those who suffer from chronic ingrown hair. Both these procedures are fairly lengthy and not inexpensive, but they may be worthwhile.

8/ Using a home-made sugar mask will sooth the irritated area of the ingrown hair while exfoliating the skin.

Heat the juice from a half medium lemon with one cup of sugar plus one and one half teaspoons of cornstarch and one quarter cup of honey. Mix to a smooth paste and let cool. Sprinkle the affected skin lightly with cornstarch and spread the mixture evenly over the skin. Leave it on for twenty minutes and remove with warm water. You may treat your skin to another such mask after three days.

Types of Inflammatory Bowel Disease and Their Symptoms

The two major types of the Inflammatory Bowel Disease are:

• The Ulcerative Colitis (UC) which only affects the colon (the large intestine).
• The Crohn Disease (CD) which mostly affects the small intestines although it can actually affect any part of the digestive systems; starting at the mouth and ending at the anus.

Because both these types of the Inflammatory Bowel Disease are chronic and, therefore, last for an extended period of time, they run through varying courses of intensity and severity. When the inflammation is acute, the disease is said to be active. When there is an easing of the inflammation or an absence, the disease is considered to be in remission.

Depending on the intensity of the inflammation and its locations along the digestive system, the symptoms may vary from mild to brutal but most of sufferers of the Inflammatory Bowel Disease experience the following:

- Damaged intestinal walls.
- Abdominal cramps and pains.
- Bloody diarrhea which also results in anemia.
- Urgent and frequent needs to have a bowl movement.
- Fever.
- Loss of appetite that leads to weight loss.

Inflammatory Bowel Disease Complications

As if the Inflammatory Bowel Disease is not enough to deal with, it often leads to a long list of complications:

• Uncontrolled hemorrhaging from the ulcers.
• Rupturing of the bowel.
• Strictures and obstructions in Crohn Disease can be resolved with medication or surgery. In Ulcerative Colitis, strictures and obstructions are often malignant tumors.
• A fistulae is an abnormal passage which usually occurs in Crohn Disease, it often requires surgery and it tends to reappear recurrently.
• Toxic megacolon is an acute non-obstructive dilation of the colon in cases of Ulcerative Colitis. It can lead to fatalities if corrective surgery is not performed urgently.
• Whether it is the Crohn Disease or the Ulcerative Colitis, the risk of malignant cancer at the site of the inflammation is substantially raised above that of the general public.

Inflammatory Bowel Disease Treatment

It is important to follow a healthful diet which does not aggravate the condition further and then there is a long list of medications that are designed to first relieve the symptoms of the Inflammatory Bowel Disease and then to reduce the rate and length of the flare-ups with antibiotics, aminosalycylates, corticosteroids, immune modifiers, anti-TNF agents, and others. In some cases, surgical intervention is in order.

It is important to note that infertility is not synonymous to sterility. As a matter of fact, approximately fifteen percent of all heterosexual couples are infertile while only one or two percent of them are actually sterile. Statistics show that fifty percent of couples who reach out for medical help sooner or later have children either on their own or with the help of a number of medical options.

Fertility Evaluations

To determine infertility, its extent and to draw plans of action to overcome it, comprehensive medical evaluations need to be performed. The process usually begins with complete physical examinations as well as the assessment of the medical and sexual histories of both partners.

The Female Partner. In women, ovulation is assessed through blood tests which detect the presence of hormones, through ultrasound examinations of the ovaries or through ovulation tests. Irregular menstrual cycles may arouse suspicion but that does not necessarily lead to the cause of the problem.

The six main reasons for women’s infertility are:

1/ The lack of ovulation (also known as anovulation) which is the ejection of eggs from the ovaries. This is usually due to the polycystic ovary disease (PCOS). Anovulation is the most common reason for women’s infertility.
2/ The failure of the fallopian tubes to transport eggs from the ovaries to the uterus. This condition is most often caused by scar tissue resulting from an infections or endometriosis which leads to blockage of the passage.
3/ Fibroid growths, tumors, cervical problems or an irregularly shaped uterus may prevent the egg from implanting in the uterus.
4/ The mucus of the cervix injures the sperm or stops their movement.
5/ Obesity.
6/ Advance age.

The Male Partner. Men go through an analysis of their semen for a sperm count as well as the sperm’s movement to verify whether they are sluggish or wandering and at what percentage. Thus far, scientists do not know all the reasons for infertility in men but recent studies show that a large percentage may be linked to genetics and the abnormality of the Y chromosomes.

The most frequently occurring reasons for infertility in men are related to sperm disorders but some are related to injuries of the testicles:

1/ Low sperm count. There may not be enough sperms or there are no spermatozoa present in the semen
2/Low sperm motility. The sperm move too slowly or inefficiently.
3/ Malformation of the sperm.
4/ Blocked sperm ducts.
5/ Overheated testicles.
6/ Testicles exposed to chemicals.
7/ Effects of alcohol and/or tobacco.
8/ Advanced age.

Depending on the source of the infertility (the male partner or the female partner) and the cause of the problem, there is a wide range of very effective options which can rectify infertility and those may be hormonal treatments and various medications, surgery and in vitro fertilization. However, none of these options are accessible without appropriate medical teams of professionals.

Types of Urinary Incontinence

There are seven identifiable types of Urinary Incontinence and they are:

1/ Stress Incontinence – a small leakage of urine which occurs when pressure is applied to the lower stomach muscles such as during physical exertion, strenuous exercise or heavy lifting, or as a reaction to a sudden and abrupt jerking movement such as coughing, sneezing or hardy laughter.
2/ Urge Incontinence – A large leakage of urine which transpires unexpectedly during wakeful hour as well as during sleep and it is a condition by which the need to urinate is so pressing that there is no way of holding it long enough to make it to the toilet.
3/ Overflow Incontinence – A small leakage of urine when the bladder gets full.
4/ Functional Incontinence – This is urination before reaching the toilet and it may be due to a physical disability or some external obstacle. It may also be due to problematic thinking or communicating that led to a delay in getting to the toilet.
5/ Overactive Bladder -  A urinary frequency with urgency and it may go hand-in-hand with Urge Incontinence or without.
6/ Transient – This is a temporary condition in which leakage of urine occurs due to an infection, some new medications or an illness.
7/ Mixed – A combination of any two or more of the above Urinary Incontinence conditions but it most frequently appears as a combination of the Stress plus the Urge Incontinence.

Training the Bladder

There is a way to control Urinary Incontinence, particularly the Stress Incontinence, Urge Incontinence or the Mixed Incontinence, and that is by training the bladder to reduce the frequency of trips to the toilet, to increase the bladder’s capacity to hold urine and to strengthen the control over the urge to urinate.

Currently, there are three methods by which to train the bladder in order to decrease or eliminate Urinary Incontinence mishaps:

1/ Kegel Exercises – Named after Dr. Arnold Kegel, these exercises strengthen and tone the muscles which form part of the pelvic floor and these are the same muscles used to stop the flow of urine. The Kegel exercises are effective for women as well as for men and they are performed in the following way:
- Quick pumps beginning with 15 repetitions and working up to 100 repetitions twice daily.
- Contracting the muscles slowly, holding for five seconds and then releasing them slowly. This should be repeated 25 times twice daily.
- Slowly contracting muscles part of the way, pausing, contracting them a little more, pausing and then continuing the contraction to its maximum. This should be performed ten times and twice a day.
2/ Delay Urination – Works particularly well with Urge Incontinence and the object of this exercise is to postpone trips to the toilet. It should start with waiting five minutes and then slowly increasing it to ten minutes, fifteen minutes and so on, until the number of visits to the toilet are down to three or four per day.
3/ Scheduled bathroom trips – This exercise makes toilet visitations consistent and preset whether the urge is there or not.

There are other remedial steps which help Urinary Incontinence such as drugs, devices and dietary adjustments but these should all be discussed with a medical professional.