Hair loss Treatment Center

PARTICIPANTS Gerard Guillory, MD Assistant Clinical Professor of Medicine University of Colorado Health Sciences Center EDITORIAL CONSULTANT James F. Marion, MD Assistant Clinical Professor, Mount Sinai School of Medicine

ANNOUNCER: Shannon, who is 29, is a dedicated, recreational runner, who likes to compete in marathons.

SHANNON: It's always nice, when you go out for a run, to be able to go at the pace that you normally go, to be able to race a race in top form. And being bloated and backed up, it becomes very difficult to do that. You feel really lethargic, really slow, you can't go as fast, or do as many things as quickly.

ANNOUNCER: Shannon's constipation and bloating also interfered with social activities, and with work and travel.

SHANNON: It would get so bad that, for example, on a business trip I could not go to the bathroom for six days, which, for people haven't experienced, they might not understand what that's like. It's so painful. It's like you feel like you're about six months pregnant. Your stomach is way out. You're completely bloated, very lethargic, but you're unable to go to the bathroom. You're unable to pass gas. And so you are completely backed up to the point where you are just absolutely miserable.

ANNOUNCER: Finally, it got so bad, Shannon couldn't keep her problem to herself any longer.

SHANNON: I didn't really talk much about it to people at first, because I thought it was a little bit embarrassing. But soon I just decided, "You know what? This is miserable."

ANNOUNCER: Shannon made an appointment with Dr. Gerard Guillory, an internist whose practice includes many patients with bowel problems. He quickly suspected irritable bowel syndrome, or IBS.

GERARD GUILLORY, MD: Simply stated, IBS is abdominal pain or discomfort. That's the cardinal feature of IBS. The abdominal pain or discomfort is associated with altered defecation, either diarrhea on the one hand or constipation on the other hand. Some patients alternate between diarrhea and constipation. Shannon fell into the IBS-C, or IBS with constipation category.

ANNOUNCER: Shannon was particularly anxious to avoid some of the techniques that are sometimes used to diagnose intestinal disorders.

SHANNON: I was concerned that Dr. Guillory would want to do an invasive technique, a colonoscopy or something of that nature. And because of the sensitive subject matter, I really didn't feel comfortable with that. I went in there with the expectation and let him know that I really wanted to see if there was something we could do that could help me without going the route of invasive procedures.

GERARD GUILLORY, MD: One of the things that I often do in the first visit is tell them up front that there's not going to be any exam involved and that all we're going to do is talk about it. And they fill out a rather lengthy questionnaire to get at the heart of some of the symptoms that I think are important for making a diagnosis of IBS.

ANNOUNCER: Dr. Guillory determined that Shannon had no alarm symptoms that might indicate a more serious disease or condition, so he diagnosed IBS and began treatment.

GERARD GUILLORY, MD: For patients with IBS and constipation, one of the first goals of therapy is to try and get the bowel movement more regular, and often times I will try fiber supplements as a first-line treatment. And that's what we did with Shannon.

ANNOUNCER: Dr. Guillory also wanted Shannon to work on her schedule.

SHANNON: He wanted me to basically, what he calls, adult potty training, where he wanted me to have an exercise every day where I went to the bathroom and relaxed and tried to sit there with a magazine or a newspaper for a prolonged period of time to try and reeducate my body to go to the bathroom in the morning when I first wake up. So I did try that, as well.

ANNOUNCER: But Shannon continued to have problems with constipation and bloating, and she went back to Dr. Guillory a few weeks later.

GERARD GUILLORY, MD: I saw Shannon for follow up after we had tried fiber and establishing a consistent time for elimination. She was marginally better but still having quite a bit of problems with the discomfort and irregularity.

ANNOUNCER: Dr. Guillor assured Shannon there was no reason for despair. He explained to Shannon, as he does all of his patients, there are always next steps in the treatment of IBS.

GERARD GUILLOR, MD: "Here's what we're going to try first, and if that doesn't work we're going to try this and this and this," so they realize, if they don't become too frustrated if the initial intervention is ineffective, just to let them know up front that there are other options.

ANNOUNCER: The next step for Shannon was a prescription drug that stimulates the intestine, speeding the transit of stool. The treatment was effective and quick.

SHANNON: Well, immediately I knew it was working. I took it the following morning when I woke up, before I ate my meal. And within an hour or two I was able to go to the bathroom successfully.

GERARD GUILLORY, MD: I saw her in followup, and she was markedly improved. She's a very active girl, likes to run, and this had significantly improved her quality of life.

SHANNON: Well, running is a lot easier and more fun now, because I'm able to go to the bathroom before I go, so I can go out for my runs. I can do my pace work, my speed work, my long runs, all of this, without having to worry about the bathroom or when I'm going to be able to go next or my bloating or abdominal pain. I mean, it's absolutely fantastic. It's like I'm a new person.