GI Disorders

1. We are indebted to Engle and Whitehead at the Institute of Gerontology for their work on this topic.

2. Note prevalence of intestinal disorders

3. Diffuse esophageal syndrome - prevalence not established but relaxation therapy seemed to help in one case that Bill treated (glottis).

4. We will cover anorexia and bulimia as eating disorders later- a bit more on rumination.

5. a. Peptic ulcers are very related to stress but are best treated with medicine. There is new evidence that stress and resulting immunoincompetence permits a bacteria to flourish. Relaxation therapy as an adjunct or second choice is ok.

b. The electrogastrogram (EGG) Robert Stern at Penn State has found that the EGG waves are dysrhythmic during nausea.

6. Inflammatory bowel disease, ulcerative colitis and Crohn's disease both respond to relaxation therapy (even tho they obviously have physical cause and some physical treatments).

7. Irritable Bowel Syndrome (sometimes called functional colitis)

a. Note pain sensitivity to balloon distension.

b. Relaxation training and stethoscopic biofeedback have been found effective.

8. Fecal incontinence

a. Encopretic children often have a sensory problem.

b. Engle and Whitehead's pressure biofeedback and Kegles

c. Dan Cox's surface EMG biofeedback

d. encopretic aged -such protocols may keep the aged out of homes and hospitals.