Parkview Publishing Nuggets

We inspire and empower people who suffer from pain, symptoms, and/or illness to heal and become healthier than ever before. Knowledge can connect you to better health by understanding and accepting the following:

In order to achieve our mission, Parkview Publishing provides books, educational materials, resources and a dynamic website, http://www.parkviewpub.com/.

 


 

Perceptions

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, M.D. and Neil F Neimark, M.D. (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

 

In his book, The MindBody Prescription, John Sarno, M.D. (New York: Warner Books, 1998) points out that contemporary medical research on the relationship of emotions to pain, particularly chronic pain, focuses exclusively on what can be called perceived emotions. This includes such feelings as anger, anxiety, fear and depression. The person who suffers these feelings is aware of them; they are not repressed in the unconscious. However, the good stress response and the bad stress response activate the emotional brain (limbic system), and the resulting symptoms of the body are not necessarily associated with perceived emotions by the mind/brain. In other words, your gut can ache without the associated emotion of fear and/or anxiety. Furthermore, special psychometric testing may not identify the perceived emotions.

 


 

ROME II Criteria

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, MD and Neil F Neimark, MD (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

 

ROME II criteria are a symptom-based diagnostic classification system for the functional gastrointestinal syndromes.

 


 

Self-Tests

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, M.D. and Neil F Neimark, M.D. (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

 

First, it is very important to recognize and accept the fact that the symptoms of functional gastrointestinal syndromes, such as irritable bowel syndrome can be related to the bad stress response and emotional distress.

Next, make certain that a drug, medication, or substance like alcohol, recreational drugs, nicotine, and caffeine is not causing or contributing to the problem. Anxiety, depression, and unpleasant digestive tract and bodily symptoms can be caused or aggravated by these drugs and substances.

Self-Assessment Screening

Here are five self-assessment "screens" that can be used to determine if there could be a problem with harmful stress or a psychological problem. These screenings only indicate that a problem may be present. Your doctor needs to confirm any diagnosis with additional questioning and evaluation. Still, these tests may alert you to the possible presence of a problem and aid you in becoming a responsible partner in your own diagnosis, treatment, and healing.

A screen for alcohol abuse

Click here to take a screening test for alcohol abuse.

A screen for depression

This book has emphasized how common it is for people to consult with doctors because of symptoms related to life stress and psychological problems. Most people with depression do not come to the doctor announcing, "Doctor, I am sad and depressed." Instead, they report real physical symptoms, like abdominal pain, headaches, fatigue, and sleeplessness.

Here is a brief screen that may allow you to recognize depression in yourself. If you answer yes to five or more of these questions (including questions #1 and #2) and the symptoms have been present nearly every day for two weeks or more, then you may be depressed.

1. Do you feel a deep sense of sadness, hopelessness, or feeling "down" most of the day?

2. Have you noticed a loss of interest or pleasure in doing most things and in most activities?

3. Have you had a significant change in appetite or weight (up or down) when not dieting?

4. Have you had a significant change in sleeping patterns (trouble falling or remaining asleep, or too much sleeping)?

5. Do you feel especially restless and fidgety, or do you feel especially tired and sluggish?

6. Do you feel unusually fatigued with low energy?

7. Do you feel badly about yourself, that you are a failure, have let other people down, are worthless, or feel guilty about things?

8. Have you had trouble thinking and concentrating, or difficulty making decisions?

  1. Do you have recurrent thoughts of hurting yourself, death, or committing suicide?

(Adapted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1994 American Psychiatric Association.)

A screen for anxiety and panic

It is estimated that over ten million Americans have persistent anxiety that can cause or contribute to significant mental and physical symptoms.

Generalized anxiety disorder

Here is a brief screen for a generalized anxiety disorder, which may allow you to check for anxiety in yourself.

Have you been troubled on most days for more than six months with excessive and unrealistic worry that you feel you cannot control? If you have, do you also suffer from three or more of the following symptoms?

1. Irritability

2. Muscle tension

3. Restlessness, feeling keyed up or on edge

4. Fatigue

5. Difficulty with concentration or with your mind going blank

6. Sleep problems (difficulty falling or remaining asleep, or restless sleep which does not restore energy)

(Adapted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1994 American Psychiatric Association.)

Panic attack and panic disorder

A panic attack is a type of anxiety characterized by an unprovoked episode or explosion of bodily sensations, symptoms, and fear, which usually lasts just a few minutes to several hours. The American Psychiatric Association defines a panic attack as an unprovoked surge of fear accompanied by at least four of the following physical and emotional symptoms (although a limited symptom panic attack can occur with fewer than four symptoms):

• Shortness of breath or smothering sensations

• Dizziness or faintness

• Accelerated heart rate

• Trembling or shaking

• Sweating

• Choking

• Nausea or abdominal distress

• Feelings of detachment or unreality

• Chest discomfort or pain

• Numbness or tingling sensations

• Hot flashes or chills

• A fear of dying, going crazy, or losing control

Sudden and intense anxiety that is triggered by situations where a person fears being the focus of others’ attention is not considered to be a true panic attack.

The difference between a panic attack and a panic disorder

The difference between a panic attack and panic disorder is the frequency of attacks or their emotional impact. A panic disorder is diagnosed if four or more panic attacks occur within any four-week period, or if fewer than four attacks are followed by a month of persistent fear of having another attack.

A screen for a somatoform disorder

In psychiatric terms, somatization is the bodily expression of the effects of stress and emotional distress. When these symptoms repeatedly bring people to doctors and interfere with living, the condition may be diagnosed as a somatoform disorder. Medical tests are normal and do not explain the many bodily symptoms of a somatoform disorder. The symptoms have usually been present or recurring for a long time, often for years. Since many of the symptoms of somatoform disorder are also symptoms of other illnesses, many tests and medical evaluations may have already been done to assure that no other disorder or disease is present.

The symptoms of somatization and somatoform disorder include:

• Digestive symptoms like nausea, gas, indigestion, abdominal pain, bloating, constipation, loose stools or diarrhea

• Fatigue

• Difficulty sleeping

• Headaches

• Dizziness

• Feeling faint or fainting

• Chest pain

• Back pain

• Menstrual pain

• Bladder symptoms

• Pain with sexual intercourse

• Pain in the arms, legs, or joints (like shoulders, hips, knees)

• Heart pounding or racing

• Shortness of breath

Somatoform disorder could be present if (1) there are three or more of these physical symptoms that have interfered considerably with life and activities in the last month, and (2) medical tests have been unable to explain the symptoms.

A screen for an eating disorder

Particularly in adolescent girls, the perceived need to gain control over one’s life can express itself as an eating disorder, either anorexia nervosa (not eating enough) or bulimia nervosa (self-induced vomiting). Young women often view themselves as heavy even when they are not overweight. There are unrealistic body appearance and weight standards in American society set by advertising and fashion models. We are led to believe that we should be thin—perhaps very thin. If one’s self-esteem is low and opportunities for assertiveness have been limited, the discovery that attention can be gained by altering the body can be powerful and eye opening. In order to maintain attention, a person with an eating disorder may continue to lose weight through a combination of continuous dieting, exercise, and self-induced vomiting, or use of laxatives and diuretics. Many people who have eating disorders also have digestive problems, and it is important to consider these conditions in the evaluation of the functional GI disorders.

If the answer to any of these four questions is "yes," then you could have an eating disorder:

1. Do you have a problem with eating and/or weight control?

2. Do you ever throw up after eating?

3. Do you ever over-eat when anxious and then throw up afterward?

4. Do you make yourself vomit or do you take laxatives to keep from gaining weight or to lose weight?

Remember, it is advisable to confirm with your doctor any problem or diagnosis that you might suspect as a result of these screens.

 


 

Sleep

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, M.D. and Neil F Neimark, M.D. (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

Click here to visit the National Sleep Foundation website.

Click here to visit the American Academy of Medicine website.

Click here to visit the American Sleep Apnea Association website.

Click here to review recent abstracts of recent medical journal research on the relationship of sleep and functional gastrointestinal syndromes:

 


 

Smoking Cessation

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, M.D. and Neil F Neimark, M.D. (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

Click here to visit the website of the Virtual Office of the Surgeon General: Tobacco Cessation Guideline.

Click here to visit the American Lung Association Freedom From Smoking® Online.

Click here to visit the MEDLINEplus Health Information on Smoking Cessation.

 


 

Spirituality

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, M.D. and Neil F Neimark, M.D. (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

Duke University Center for the Study of Religion/Spirituality and Health

Larry Dossey, M.D., deeply rooted in the scientific world, has become an internationally influential advocate of the role of the mind in health and the role of spirituality in healthcare. Bringing the experience of a practicing internist and the soul of a poet to the discourse, Dr. Larry Dossey offers panoramic insight into the nature and the future of medicine. He is the author of many books. Click here to visit his website.

 


 

Stress and Infections

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, M.D. and Neil F Neimark, M.D. (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

 

The National Institutes of Health has designated five Mind/Body centers to conduct research on the interactions between the mind and body in health and disease.

 


 

Stress Management

This is supplemental information for this topic marked by the little computer icon in the book, Irritable Bowel Syndrome and the MindBodySpirit Connection, by William B. Salt II, M.D. and Neil F Neimark, M.D. (Columbus: Parkview Publishing, 2002). Click here to learn more about the book and/or to purchase it.

An excellent resource regarding stress and mind/body medicine is the Harvard Mind Body Medical Institute, Herbert Benson, M.D., founder and president.