Cybill Shepherd Leads Amazing Women Campaign to Help IBS Sufferers Get Relief

NEW YORK — Cybill Shepherd, the National Women’s Health Resource Center (NWHRC) and Novartis Pharmaceuticals Corporation announced that they are working together to launch the educational campaign Amazing Women.

The campaign is designed to empower women to seek proper diagnosis and treatment for recurring constipation accompanied by abdominal pain or discomfort and bloating, the hallmark symptoms of Irritable Bowel Syndrome (IBS) with constipation, a dysmotility disorder.

IBS with constipation often goes undiagnosed for years. A new RoperASW survey, IBS with Constipation: The Barriers to Doctor-diagnosis and Treatment, found that as many as 96 percent of undiagnosed sufferers do not realize they have IBS with constipation, a treatable medical condition, even though 88 percent of those who had not spoken to their doctor knew about the condition. Respondents also cited embarrassment about discussing their symptoms as a reason for failing to communicate openly with family, friends and even their doctors.

Shepherd is one of 6 million Americans who suffer with dysmotility symptoms associated with IBS with constipation. Until recently, she was like most of the respondents in the RoperASW survey, in that she didn’t realize she had a treatable medical condition.

“I struggled with recurring constipation, abdominal pain and bloating for more than 20 years because I didn’t talk openly to my doctor about all of my symptoms,” says Shepherd. “I tried nearly everything, including fiber supplements and over-the-counter laxatives, but none of these helped relieve all of my symptoms. Sometimes I was not able to enjoy my free time, including the activities I did with my kids.”

Shepherd will work with NWHRC and Novartis to engage women who have been diagnosed with IBS with constipation to encourage them to offer support to others who are suffering with recurring constipation, abdominal pain and bloating but who remain undiagnosed. These patient advocates will share personal stories that led them to the right diagnosis and treatment with Zelnorm® (tegaserod maleate), the first and only medication approved by the Food and Drug Administration (FDA) for the treatment of women with the multiple symptoms of IBS with constipation.

“When I finally opened up and told my doctor the whole story, she was able to diagnose my condition and prescribe Zelnorm, a treatment that finally helped to relieve all my symptoms,” Shepherd says. “My goal is to urge all woman to get over their embarrassment, to stop suffering in silence the way I did, and to talk to their doctors. Getting the right diagnosis and treatment can help us to be the amazing women we were meant to be.”

CORRECTION

In the EndoNurse Buyer’s Guide (October/November 2004) Integrated Medical Systems International Inc. was incorrectly listed as “Intergrated Medical Systems International Inc.”

We sincerely apologize for the error and for any inconvenience it may have caused.

Integrated Medical Systems International Inc.
1823 27th Ave., S.
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Phone: (205) 414-6852
Fax: (205) 414-6852
Toll Free: (800) 300-7899
Web: www.imsservices.com

Integrated Medical Systems International, Inc. is an independent service organization for the healthcare market. We provide equipment-renewal services, proactive maintenance, education and consultation for more than 1,500 different types of equipment and accessories, including flexible scopes, rigid scopes, power equipment, video cart systems and surgical equipment.

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“Surgeons who do weight-reduction surgery and the general public and should be aware that nerve damage is a frequent consequence of the surgery,” says P. James Dyck, MD, Mayo Clinic neurologist and lead investigator in this study, presented at the American Medical Association Science Reporters Conference and published the journal Neurology. “I’m not saying that people shouldn’t have this surgery, but I am saying that there are real potential complications and that good follow- up care is necessary.”

The Mayo Clinic investigators found that 16 percent of weight-reduction surgery patients they studied developed a peripheral neuropathy: nerve problems ranging from minor tingling or numbness in the feet to severe pain and weakness confining patients to wheelchairs.

“It’s surprising how many of these patients developed peripheral neuropathy,” says Dyck. “Sixteen percent is a large number. But patients who were part of nutritional programs before and after their weight loss surgery generally didn’t develop these neuropathies, so we believe the nerve damage is largely preventable.”

Dyck and colleagues identified risk factors in weight-reduction surgery patients who later developed nerve problems: 1) they lost weight at a much faster pace, 2) they received less nutritional supplementation, 3) they experienced prolonged nausea and vomiting, and 4) they failed to attend nutritional clinics.

“The evidence is very strong that nerve complications are associated with malnutrition,” says Dyck.

Some forms of malnutrition are well recognized to cause peripheral neuropathy, such as thiamine deficiency in the disease beriberi. Rather than the surgery being a direct cause of neuropathy, the associated rapid weight loss and prolonged nausea and vomiting can lead to malnutrition and neuropathy.

An important key to preventing peripheral neuropathy is to seek a robust program with presurgical and postsurgical care by a multidisciplinary team of specialists who can oversee the patient’s nutritional status. “Don’t just choose a surgeon, choose a program,” says Dyck. “Patients in our study who were not part of programs were more likely to end up with nerve problems. This is a life-changing operation. It’s like having transplant surgery — you need long-term follow-up.”

Michael Sarr, MD, a Mayo Clinic weight-reduction surgeon who participated in this study, adds, “It’s a risky operation, but it’s a calculated risk in that morbid obesity is life-threatening. Obesity can cause sleep apnea, diabetes untreatable by insulin, excess fatty substances in the blood, and coronary artery disease. Weight-reduction surgery shouldn’t be taken lightly, but it has tremendous benefit to select patients.”

Dyck and colleagues embarked on this study due to a pattern they observed in the peripheral neuropathy clinic. “We’d seen patients with nerve problems in our clinic who’d had weight-reduction surgery,” he says. “We saw the association, and we wanted to test it in a scientific way.”

The investigators searched the charts of 435 patients who had undergone either Roux-en-Y gastric bypass or vertical banded gastroplasty, also known as “stomach stapling,” at Mayo Clinic or other medical institutions to determine who later developed peripheral neuropathy. Three nerve disorders were identified in the study patients: 1) sensory predominant neuropathy, marked by pain and/or sensory loss, usually in the feet, 2) mononeuropathy, involving individual nerves, as in carpal tunnel syndrome, and 3) radiculoplexus neuropathy, marked by weakness, sensory loss and/or pain in a patchy, multi-focal way. Radiculoplexus neuropathy can have the most serious consequences of the three, including confining a patient to a wheelchair.

To ensure that peripheral neuropathy was not linked to just any abdominal operation, the team also identified a control group of 123 obese patients who had undergone open gallbladder removal, another abdominal surgery. Only 3 percent of the control group developed a peripheral neuropathy.

“This is highly statistically significant,” says Dyck. “We believe that the peripheral neuropathy relates specifically to the weight-reduction surgery and not just any type of abdominal surgery.”

Dyck and colleagues have not yet studied whether these nerve problems are reversible. “We don’t know what the long-term outcomes will be for these patients,” he says. “Nerves can re-grow, and there are people who have improved.”

According to Dyck, this is the largest and most systematic identifying patterns of neuropathy in weight-reduction surgery patients. It also is the first to use a control group to look for an association between weight-loss surgery and nerve problems, and the first to identify risk factors for developing peripheral neuropathy.

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