Multiple Gastrointestinal Problems

I will be as concise as possible. Since 1990, I have been diagnosed with
Irritable Bowel Syndrome, extensive diverticulosis throughout my entire
colon, hemorrhoids, a large 6-7 in ventral hernia, small umbilical
hernia, sliding hiatal hernia, GERD, esophagitis, Barrett's Esophagus
and Schatzki's Ring. All of these problems have been confirmed numerous
times over the last 20 years. This doesn't have any bearing on my
question, but for informational purposes, I also have a neurogenic
bladder (diagnosed in 1984) requiring intermittent self-catheterization
2-5 time daily.

I am trying to establish a "most likely" link between these GI problems
and need a doctor's confirmation of that. My theory is this. These
issues first began with the IBS. The exact cause of my IBS is unknown
but I guess that it was probably caused by some type of bacterial
infection. More than ten years passed before I was actually diagnosed
with the IBS, which was diarrhea predominant at the time. I believe the
sudden filling of my bowels during episodes of diarrhea, and the
pressure in my colon during episodes of constipation, along with
straining to have bowel movements, caused my hemorrhoids and
diverticulosis. I further believe the IBS which causes my near constant
abdominal pressure, distention, bloating, and cramping, coupled with
straining during bowel movements, caused my ventral, umbilical and
hiatal hernias. As a result of the hiatal hernia, my minor reflux (GERD)
problems worsened, which in-turn caused the esophagitis, Barrett's
Esophagus, and Schatzki's Ring.
  
My questions are specific for a purpose. Please elaborate where
necessary with your answers.

1. Is it at least as likely as not, that my diverticulosis and
hemorrhoids were caused by my IBS as stated in my theory above?

2. Is it at least as likely as not, that my ventral hernia, umbilical
hernia, and/or hiatal hernia were caused by the complications of my IBS
as stated in my theory above?

3. Is it at least as likely as not, that my GERD worsened as a result of
my hiatal hernia as stated in my theory above?

4. Is it at least as likely as not, that my esophagitis, Barrett's
Esophagus, and Schatzki's Ring were caused by my GERD?

Thank you!

[ggreg]

On your No. 2 question, hernias can happen for a variety of reasons.  But it is true if your belly is all swollen, and perhaps you get to coughing, you might get a hernia.  This is because the muscles that normally hold in the gut are stretched from swelling.  Hernias can ALSO be caused by ordinary physical activity, where you strain to do something difficult, which can include things like lifting something to heavy.  As to whether straining to pass waste would cause a hernia, I am not convinced that your IBS is the cause.  This is because a hernia is when a muscle tears, and IBS in and of itself doesn't do that, nor do I believe straining can, at least not the ones you have.  But I'm not an expert.  I just have IBS.

On your No. 3 and 4 questions, the reason for GERD, esophogitis, Barret's esophagus, and Schatzki's Ring, the last three probably come from the first one, GERD.  When a lot of acid bubbles up from the tummy, it can get in the esophagus and create problems in there.  So, looking at your GERD, I think it is more likely that, instead of coming from the hernia, it comes from your intestines having a problem.  Most people who get indigestion, their pH levels will also become quite acidic. There are various ways to reduce the acidity in the body, to include ordinary alka seltzer, all the way up to prescribed medicines like hyoscyamine.  You are probably already taking all sorts of stuff to help your esophagial problems heal up.

So, on your No. 1 question, about if IBS caused your diverticulitis and hemorrhoids, I think they are more relative than causative elements.  Diverticulitis can be caused by a variety of things, therefore you cannot say it is this or that which caused it.  Only a physician can decide what might make your bowels prone to diverticulitis.  Now, hemorrhoids are almost always caused by straining when you pass waste.  Tissues swell from straining, and this is what hemorrhoids are.  Straining happens when waste is dry and builds up in the intestine, and is hard to pass, so vascular tissues swell up from the pushing and hurt/bleed when waste goes by them.

Now, you have IBS with both diarrhea and constipation.  Often medical articles will say IBS with one or the other.  Anyway, let me explain the basic way to prevent constipation, despite the IBS diagnosis.  The three things to do to stop constipation is to drink plenty of water, get plenty of exercise, and get enough fiber foods in the diet.  That's the simple word on preventing constipation.   Enough water is about five or six glasses a day, drink them after you brush your teeth to establish a habit.  Exercise helps the bowels move better because they keep the muscles in the abdomen strong.  Fiber foods include things like whole grains, fresh vegetables, and fruit as a snack.  

But there are other elements that figure into constipation that you can stop to end it.  One is whenever you finish a round of antibiotics, which can dry out waste, is re-introduce probiotics to the gut, by things like drinking Acidophilus milk or eating Activia yogurt for two weeks, to reintroduce the "good bacteria" that antibiotics kill.  Two is to review medications you take regularly and see if any of them can cause digestive problems, which one side effect is listed as "dry mouth," among other things, and if so, change to another kind of drug.  Three is if you take an ordinary vitamin and mineral supplement, some of those can dry a person out, so you need to either only take them once or twice a week, or switch to another kind until you find one that doesn't stop you up.

Now, IBS with diarrhea, I can tell you from my own experience, because I had that from a medication I was on, and I think it was Ativan, altho it could have been Lexapro.  I had to quit both medicines, once I realized they were the cause, and as soon as I let them go, my digestion returned to normal, I dropped a lot of unneeded weight, and my gut swelling went down.  I think it is very important to have your doctor review all medications you are on, including herbs and other supplements, and decide which one MAY be causing your IBS, and then switch you to a less irritating drug.

You should also do a general search online for the causes of diverticulitis, because it could be if medication is not the culprit, then it's some other lifestyle habit that is doing this to you.  As you know, eating a lot of seeds and certain nuts, and other smallish/hard foods, will cause diverticulitis pockets to form.  Also, amongst the causitive reasons for your bowel doing this can be traced to bacteria or toxins introduced to the digestive tract.  It could be if a list of causes of diverticulits match up with anything to do with yourself, you may be onto something, as to why you have IBS.  

But there is most definitely something that has weakened your digestive tract somehow, could be from a long time ago, or could be something ongoing.  If it's something from the past, and the damage has been done, then you must be on a really good medicine to protect the lining of your digestive tract so it can heal.  If it something ongoing, then all the things I've told you should hopefully lead you to figure out how come all this terrible stuff is happening to you.