It has been quite some time since I last addressed the issue of IBS and back or lower back pain. But due to the overwhelming readership the articles I have published have gotten and the amount of reader emails I have received I feel it is time once again to address the issue and hopefully bring some notoriety to the subject. My findings over the last few years have been most enlightening.

I have long been a proponent that in some cases IBS is, or at least seems to be directly linked to spinal injury or damage. In my case it seems that way, as it does for hundreds of others who have written me, telling their stories in emails.

I want to personally thank all those that took the time to dig and find my email address. I have to admit that I usually have not made it easy. So those that did actually get an email through, and there have been many, I know had to expend some effort to actually find the email address.

Recently I got an email from a Retired Navy Master Chief who recently read my article on “Lower Back Pain and Irritable Bowel Syndrome” It is because of him, I guess that I have since been prompted to get off my keester and publish something. His story is much like my own, in fact the only difference I see in his story and my own are possibly the manner in which his back injury was delivered and our occupations.

The more email that I receive from people telling me very similar stories about their experiences with Irritable Bowel Syndrome; the more I am convinced that there is a definite link between back/neck or spinal injury and the onset of IBS.

It goes without saying that nerves that control gut operations get to and from the brain via the spinal column. So it only stands to reason that any amount of damage to those nerve corridors, conductors and conduits could and most probably do have an effect on the overall digestive system operation. It also stands to reason the worse the injury or disruption of nerve impulses to the gut, the worse IBS symptoms could or will possibly be.

I am not a doctor or spinal specialist, nor do I profess to have any knowledge but that which I personally have acquired during my own long battle with IBS, and from the accumulated knowledge of being able to compare stories sent to me by hundreds of other IBS sufferers.

There is something that I feel I must mention that I find quite profound. I have been writing and publishing in one manner or another about IBS for about 10 years now, maybe more. It was not until I published about my own observations regarding my conclusion that there was a correlation between my own spinal injury and IBS that things seemed heat up.

Once I published the first article where I suggested the connection between back pain or spinal injury and IBS, I started to get emails from many other Irritable Bowel Syndrome sufferers. Like I said, they had to dig to find my email address and be able to send me their stories, yet they did. This tells me that there has to be more than my own observation and speculation involved here.

Since the time of the first article where I asserted that there was a connection between back pain and IBS, I have received hundreds of emails from readers that were moved enough to actually take the time to tell their stories. After reading their stories, I was saddened as there was nothing I could tell them at the time that would help them. For most to whom I replied, my main suggestion was to demand that their primary caregiver at least consider the plausibility of the connection between spinal injury and IBS.

I know from my own personal experience with over 7 doctors that for them to consider something that isn’t currently in their neatly categorized and cataloged list of symptoms and solutions, it is almost impossible to get them to consider anything else as a possible cause. Heaven forbid that a layperson should be able to tell a “doctor” anything. I have to admit that I only broached the subject with three physicians, and the result was less than hopeful.

Each one took a note, or supposedly took a note of what I had to say, and promptly moved on to the IBS play book. I call it that because all doctors seem to have the same mentality when it comes to IBS The only way to diagnose it is to go from test A to test B and then C and so on and on regardless of the results, regardless of how much of your money they spend on tests, tests that had they actually read your history they would have known had been done over and over already.

Until I got my last email from a reader I had almost given up hope that the medical profession would even consider the theory of spinal injury in relation to Irritable Bowel Syndrome. And I quote from the Master Chief’s email, “Like you I’ve experienced the same symptoms for almost 15 years now. One of my PAs over the past two years introduced the thought that my problem was the result of some physical trauma.” Personally I find this to be astounding, the first time I have ever encountered a person in the medical profession that would even consider such a thing. Granted the person was only a PA (physician’s assistant) but it’s a start. The Master Chief had previously outlined to me an accident he had been involved in many years earlier which involved a head injury, but from his description could have easily involved a spinal injury as well that may have gone undetected. Who can say for sure?

He goes on to give a brief history of his condition and then at the end of his email he says something I feel is indicative of not only my own experience, but also those of almost everyone who took the time to email me their stories. And again I quote” I’ve had three Colonoscopies in the past ten years with nothing found. I’ve done my best investigation to identify my “trigger” by taking certain foods (dairy, caffeine, breads, sugars, etc.) out of my diet to no avail. Right now I’m taking Align, which seems to help, but in no way makes life normal. I’m only 48 and I keep telling myself that I’m not supposed to feel this way at my age. I keep looking for the “silver bullet”, something that will make everything all right- don’t we all though.”

His story could just as easily be my story, and the sad fact is I don’t have any hard evidence which I can point to as progress in the right direction for IBS suffers. What I do have is a few more years of experience battling the beast. And during that time I have discovered some things for myself that have actually seemed to help me, and I stress” me”. What I am about to impart is what I have done that has helped me battle IBS and made my life somewhat better over the last few years since I started publishing about back pain and IBS.

My “brand” of IBS and its cycle in my life has the typical symptoms associated with Irritable Bowel Syndrome. Things such as constipation, diarrhea, bloating abdominal pain and most of the other classic symptoms, but there never seemed to be a set pattern, and there was no way to tell which symptoms would occur. For me IBS seems to be a type of cyclic happening. Actually coming to that conclusion took me almost 20 years to figure out. Not because I am stupid, but because my back injury transformed over those number of years.

To make a long story short, I had a very bad back injury when I was a young man. At the time I was told that my only options were one, spinal fusion of L1, L2 and L3. After finding out what that would actually mean as far as mobility was concerned, I decided to go with option 2 which was to let nature take its course and see if things would heal on their own to a manageable condition.

After about a year of recuperation, I did get better. I went back to work and only had occasional problems with my back for about 15 years. Then things seemed to get worse with my back. During the 15 year period I had continued problems with Irritable Bowel Syndrome that was contributed to a gallbladder issue but never acute enough to be operable until way late in the game. That’s for another article and not actually relative to the findings and conclusions I intend to draw attention to here.

As my back seemed to worsen, I began to take Ibuprofen to control the pain because it worked. I finally went to a spinal specialist who diagnosed me with Spinal Stenosis, as well as having severe degradation of the lower lumbar vertebra. Nothing I had not expected, but also not much they could do.

I was able to manage my back pain so well with continued Ibuprofen use that I didn’t think about it much for quite some time. What did bother me was the increase in the symptoms of IBS. They got worse and worse and seemed to be more frequent. Instead of having symptoms that came on and lasted a few days maybe once or twice a month I now had symptoms that lasted weeks, sometimes a month or more with no relief. It really wasn’t easy to identify the cycle. Because the way it happened for me, it was hard to associate the two.

I would start to notice a change in my bowel movements over a period of several days which was something I had long experienced. It might be constipation or it might be diarrhea, there was never really any pattern there. But there came a point a few years ago, that my back would cause me problems enough that I would take as many as 4 200mg tabs of Ibuprofen as often as every 4 or 6 hours because the pain was getting that bad. So now I am dealing with back pain and IBS in a much more noticeable fashion.

It took me a long time to notice that when the IBS started to rear its head, that shortly after, meaning 2 to 4 days after the IBS started up, I would have a bad episode of back pain. I would take more pain medication. My back pain would get better, my IBS would get worse. After maybe a of week of taking things easy, my back pain would settle down and later on my IBS would begin to mellow out. That is if I didn’t go and do something to irritate my back again, then the IBS wouldn’t let up until the back pain eased up again. And thus I associated finally causation with my symptoms.

When the though actually occurred to me that the two things, back pain and IBS were related, I set out to prove it if to no one other than myself. I quite taking the ibuprofen altogether, instead when the pain would start I would mark that indeed the IBS symptoms had preceded the back pain. I noted that as the back pain got worst so did the IBS. Now the issue was how to treat the back pain without making the IBS symptoms even harsher.

My provisional solution was to try chiropractic’s. So for a time, when I would feel the Irritable Bowel symptoms coming on, I would go see my chiropractor. By doing a lower back manipulation or sciatic relief procedure, the inflammation in my lower back would be relieved, thus the pain would go away for however long, and the IBS symptoms got better.

So for me this is what I believe has been occurring on a semi regular basis. Through normal everyday work and movement the joints in my back would become inflamed, including the many years before the pain got to the point of needing regular management. Even though there was surely inflammation in the early years, the pain was negligible or possibly even imperceptible. Let’s face it; we all deal with a certain amount of pain to some degree or another in our lives. My pain was such that I could do little or nothing about it, and had the ability to ignore or accept it.

My GI tract on the other hand, I believe was more perceptive of the inflammation. So my theory is such that when the inflammation starts, nerves that control the entire GI tract are affected in so much as the signals to and from the brain via the spinal cord are either suppressed or strangled off at times. As the inflammation subsides, the nerve signals once again are able to connect properly and the Irritable Bowel Syndrome symptoms begin to diminish.

As for the fact that the IBS became worse with prolonged use of ibuprofen is an easy concept to understand. Look at all the reports of stomach ulcers and bleeding caused by ibuprofen. Continued use served to exacerbate an already inflammatory condition in the gut.

So for now this is my solution. No NSAID products of any kind if it can be helped. Narcotics and I don’t mix well so even though I don’t like the risks of acetaminophen products, they unfortunately have to play a small role. My back pain is managed almost entirely by chiropractic and muscle manipulation now and my IBS is markedly better.

Is it a total cure? Absolutely not, but if I had to put a percentage on how much better it is I would have to say 65 to 70% better. And yes the IBS symptoms still occur prior to my back pain onset. And because I am a rather stubborn person, I always wait to see that my back does or will actually require manipulation before I go have it done. And on occasion, about 1 out of every 4 episodes of IBS, there will be no back pain and the symptoms will subside in a day or two.

Is this to say that there is a deeper rooted causation for my particular Irritable Bowel Syndrome symptomology? I cannot say with any certainty. But I do believe that the majority of the time it is directly related to my ongoing problems with my spine. And it may be that even though there is no perceptible back pain for the small amount of times that the symptoms occur without the back pain, that the inflammation is indeed still the root cause. Even having said that, I never go in for manipulation right away when the IBS symptoms begin, I always wait for the back pain begins or get to a moderate level.

Stubborn also translate into cheap. I don’t like paying for those $80 to $120 visits to the chiropractor. So how long I suffer with the recurring symptoms each time is relative to the amount of money I have, or am willing to part with and how quickly I am willing to do it. Insurance only goes so far.

The conclusion I have come to for myself. And I cannot stress enough that every case is going to be different. But for myself, I am certain that my back injury plays a major role in my Irritable Bowel Syndrome. I am further convinced that the taking of NSAID pain relievers made my condition even worse.

I further conclude that by finding alternative methods to control pain such as chiropractic manipulation and muscle massage, I have been able to significantly decrease the severity and also the frequency of my IBS symptoms.

So, it might be worth your while to investigate for yourself these things I have talked about in connection with your own IBS symptoms. I have no affiliation with any chiropractic association or massage therapy entity that would compel me or compensate me for stating the things I have. Even if you don’t feel you have a spinal injury or condition where by inflammation of the spine might be occurring, it might not hurt to seek out a local chiropractor and have an exam or just go in for a through manipulation and judge for yourself the results.

Keep in mind that for many years I had pain that I was able to almost totally ignore. We train ourselves to live with pain, not that it’s what we should be doing, but it happens. So it might be possible that others who have IBS also have ignored back, spine or neck pain that could be a contributing factor in the Irritable Bowel Syndrome symptoms that are exhibited in their particular “brand” of IBS.

I do not contend that the information that I have given about what has been helpful for me will be the solution for everyone or for anyone for that matter. But I do think it’s important to keep up a dialog of sorts to keep hope alive. If you have suffered long with the symptoms, you know own too well how hard it is to find any kind of practical medical support and how little hope that the medical profession has given us as far as any type of cognitive answers regarding causation or subsistence of symptoms.

My hope is that the information will lead other IBS surfers to reexamine their own “brand” of IBS and possibly follow a loosely carved path to find at least some relief. Further I would not try to assert that my symptoms are completely gone, nor do I conclude that all of my IBS symptoms are related to my spinal condition. But to me, the evidence is too compelling for me not to concede that my IBS is at least moderately connected to spinal injury.

Copyright © 2011 Scott Best

Some times
when attempting to talk about or deal with Irritable Bowel Syndrome one has to
take pause and consider whether what one has to say is relevant or helpful in
any way. It’s so easy to get caught up in the personal experience of what IBS
brings to life that making a point rather than telling the personal side of the
story gets lost, or at least seems to.

And as I pondered this thought something inside assured me that even just
telling the story sometimes is relevant, sometimes just sharing the personal
experience is important. It’s important for so many reasons that to not tell the
story might be worse than not trying to help at all.

Every day I come across more and more people who like me, have suffered for
so many years in obscurity or ridiculed silence, that for me at least it’s
important to tell the story, to share the experiences, to let those that suffer
know they are not alone in their struggle.

It just might be that by telling the story from enough different
perspectives, after digesting enough information from enough sources there might
be a revelation of sorts, the moment when we connect the dots from enough
experiences that a cure or causation might be found.

In my last article I addressed the issue of the proper diagnosis for IBS, and
again, I am dealing with this issue. It has been many months now since I spoke
of the issue with my gallbladder that went acute and needed to be removed.

I t was shortly after the surgery was when I wrote about the change that had
taken place. About how after the surgery, I seemed up to then at least to be
almost symptom free. Alas the feeling of freedom did not last. I must admit that
the symptoms of my IBS did seem to be gone for many months. But the euphoric
feeling of being free from Irritable Bowel Syndrome was relatively short lived.

I did get almost 6 months of life without IBS symptomology, which was great
while it lasted. I was almost sure, for a while that my diagnosis had been
incorrect, and that removal of the gallbladder was the definitive cure for my
condition, but it wasn’t to be so.

Like I stated, there was about a six month void where IBS wasn’t a part of my
vocabulary. But slowly the symptoms returned to their previous height of
pervasiveness whereby almost monthly now my life is placed back into the one or
two week cycle of pain bloating constipation and diarrhea.

Not only that, but from time to time I get the hard pains that were
associated with the gallbladder problem. I don’t understand this at all. I have
read where there have been rare instances where some people have actually had
two gallbladders with both causing issues that required attention. It seems that
in all the cases I researched the second gallbladder was missed in most every
test performed because it was hidden under a fold of the liver.

It just seems so ironic; to have so many things going on that a good
diagnosis can’t be rendered. Now the question needs to be asked in my case, am I
one in a million that truly has a second gallbladder, or is the pain that I am
experiencing just another facet of what seems to be my ever changing list of
symptoms caused by the IBS condition.

This situation brings almost nightmarish thoughts to mind of how to even get
a doctor to consider the possibility that I might have a second gallbladder that
is in need of removal. I spent so many years and so much money trying to get
them to believe me about the one they removed. I am still not exactly sure which
made more of an impact, the fact that the gallbladder was so bad that it was
life threatening or the fact that I threatened to kill the attending physician
in the emergency room because of the pain I was in the night it nearly ruptured.

The second set of unanswered questions that haunt me would be, is my
diagnosis of IBS still wrong? Do I actually have a second gallbladder? If so,
how will I ever get a doctor to consider the possibility of a second
gallbladder? Given the previous diagnosis of IBS, and the fact that I have had
my supposedly only gallbladder removed, how will I ever convince a doctor to
look any further without thinking me some wacked out hypochondriac who only
complains of pain to gain attention. The position I find myself in now seems to
be exactly where I was before the gallbladder went way wrong and caused them to
sit up and take notice. Except now there are more complicated questions to
ponder

To complicate matters even more during my writing of this article, I came
across some new information which adds another wrinkle to the garment of
Irritable bowel syndrome that I wear.

I came across some information about something called Postcholecystectomy
syndrome. Postcholecystectomy syndrome as I understand it is a condition where
the symptoms of gallbladder disease continue even after the gallbladder is
removed. Something I was never informed of prior to my surgery. So now another
new front of where to begin is added.

So now what to do? Do I have IBS, do I have Postcholecystectomy syndrome, or
do I in fact have a second gallbladder. This just keeps getting better and
better. How will I approach a doctor now and convince them that I am a sane
rational human being at this point? With all this going on, I am finding it hard
to convince myself.

Copyright © 2008 Scott Best

Is there a correlation between lower back pain and Irritable Bowel Syndrome? Researchers have long argued that IBS may be caused by abnormal functioning of the nerves and muscles of the bowel. No indication or explanation is ever given as to why this malfunction might occur. To my knowledge there has been no adequate evidence to support this assumption. More over, I have not seen, heard of or read about any studies which were specifically implemented to test this hypothesis. Because of my own observations about my own IBS symptoms, I am inclined to believe and support this hypothesis.

Some of us who suffer Irritable Bowel Syndrome have tried for many years, without success, to eliminate the often debilitating affects of this mysterious disorder. Generally those who suffer have spent a great deal of time and money, having test after test only to be told that nothing conclusive was found.

Often after years of diagnostic procedures and expensive studies, patients are told there was nothing wrong with them. Their complaint of symptoms are brushed off as imaginary or more properly put in medical terms, psychosomatic. But with the ever increasing number of patients complaining of the same generalized list of symptoms, the medical community has been forced, in at least a small part, to acknowledge the malady as something more then imaginary symptoms of hypochondria.

So what can we surmise about IBS? It is a condition or disease in and of itself? Or is IBS is a condition caused by or a symptom of some other physical, neurological or possibly even psychological problem that is as yet undetected or undiagnosed as being relative to the IBS condition? I find this to be a more plausible conclusion and will provide some insight for my personal belief that IBS is a secondary condition rather then a condition unto itself.

For years doctors have proposed the secondary condition concept in relation to Irritable Bowel Syndrome. Unfortunately, they have not yet been able to successfully document any evidence to conclusively say what might be the root cause of IBS. Moreover, I believe there is not just one cause, but several causes, all with the same secondary symptoms, which make up what is termed as IBS.

Please don’t think that it is my intent to say the IBS condition is not real, or the symptomology is psychosomatic in nature. I know from painful experience the condition and symptoms of IBS are very real. I also would venture to say because of the sheer number of reported cases, the medical community had been forced to re-evaluate their approach while dealing with patients with complaints of Irritable Bowel Syndrome-like symptoms. I am merely going to express what I personally have concluded about another possible causation for IBS which may be overlooked by the medical profession.

I would like to also toss up for consideration that IBS, with its list of many symptoms, may be a traceable progression of symptoms stemming from a single causation. I believe, in my case, this is a very valid assumption. I have as yet been unable to get any physician to agree with me, at least to the point of taking up the position on the record.

Before going any further, I think it would be a good idea to review a partial list of Irritable Bowel Syndrome symptoms. IBS may be characterized by a combination of any or all of the following symptoms:

• Abdominal discomfort or pain, usually in the lower abdomen

• Altered bowel habit

• Chronic or recurrent diarrhea, constipation, or both. May be mixed or in alternation.

• Bloating

• Heartburn

• Nausea

• Abdominal fullness

• Feelings of urgent need to evacuate the bowel

• Feeling of “incomplete” bowel emptying

• Low back pain

• Headache

• Fatigue

• Muscle pain

• Sleep disturbances

• Sexual dysfunction

More and more it is generally believed that the symptoms of IBS are produced by abnormal functioning of the nerves and muscles of the bowel. More and more I personally agree with this as a valid and plausible perception of at least one of the causes of Irritable Bowel Syndrome. With some personal observations, I hope to give light as to why I believe this to be a possible causation for many IBS sufferers. Unfortunately, what I have come to believe as the causation for my particular brand of IBS, most assuredly will not be a diagnosis for all cases of IBS.

I think we who have suffered Irritable Bowel Syndrome tend to minimalize our symptoms and pain. We have been led to believe that other than common sense changes to diet and exercise there is nothing we can do because there is no cure. Many people who suffer will suffer in silence for years before seeking medical treatment. By then, and I include myself in this group, we may have subconsciously lessened or even put aside some of the lesser symptoms that IBS causes, focusing only on the ones that cause the most pain and discomfort.

Worse yet, we are less likely to bring symptoms to the attention of a doctor by mere assumption that it is just another facet of our complex disorder. This could become a dangerous scenario for anyone who suffers from IBS. We may ignore persistent symptoms that have gotten more intense or new symptoms that seem to be related only because we are discouraged by being told there is nothing anyone can do.

Doing these kinds of things could lead to serious life threatening symptoms being overlooked. Symptoms of conditions that, unlike IBS, can be treated if caught in time. Things like colon cancer, stomach cancer, esophageal cancer or many others, might be missed because we want to ignore our IBS symptoms after so many trips to the doctor.

My story of IBS starts over 20 years ago when I was a young man of 26. While helping lift a very heavy cast iron wood burning stove from the back of a pickup truck, the other person lost their grip and the load all shifted down hill onto my back. I felt my back give way as the stove went crashing to the ground at my feet. I knew I had sustained a serious injury. I couldn’t erect myself from the 90 degree bent forward position I was in. I had to literally pull my self up by using my hands and arms against the side of the pickup.

Being 26 and stubborn and thinking that I was invincible, I had my wife help me home and to bed, not bothering to go to the emergency room. I had some left over pain killers which numbed the pain enough to allow me to sleep. When I awoke in the morning I was horrified as I could not feel my legs. They were both cold and numb to the touch. I could move them, I just couldn’t feel them. After about 30 minutes of movement the feeling began to return to my legs and at that point I knew it was time to get to the doctor.

After the examination and x-rays what the doctor had to say wasn’t pleasant to hear. He told me I had two options. One was to go to a surgical specialist and have fusion surgery on several of my lower lumbar vertebra because the discs between them had been severely compressed. He mentioned that having this type of surgery would reduce my physical mobility by as much as 30% or more. At best, he explained, the surgery was about 40% effective.

My other option, he told me, was time… time allow let my body try to heal itself. He explained I would probably never be as good as I was before the accident, but with time my body should partially heal it self. He told me the inflammation which was causing the pain and partial paralysis should lessen. At age 26 loosing permanently 30% or more of my mobility was an unthinkable option. At least the second option offered some hope of recovery. He gave me muscle relaxants and pain pills and that was that.

I trusted this doctor…we were good friends. We had a good personal and professional relationship. I took him at his word. By today’s medical standards, his medical advice probably wouldn’t hold water, but over 20 years ago, it was most likely a very good perception of my problem.

For the next 6 months, I would wake up to cold, numb legs and each day, but as he said, the symptoms gradually got better. I was so focused on my back injury improving; I didn’t pay attention to other, minor things going on which had become bothersome.

The first and most prevalent symptom was a change in my bowel habit. Not a big change, but it seemed that instead of a daily movement, it was now once every other day, and it took a bit more effort. But with the back issue, it seemed minor in comparison and for several years seemed to be the only symptom. My back continued to get better but my bowel never did return to normal.

I have always been a large person, in 1986 at the age of 26: I weighed about 220 pounds, standing 6 feet tall. Slowly, my weight began to rise. I attributed my initial weight gain to a lessening of physical activity over the first year or two of my back problem. By the end of the second year, my physical ability and activity had almost returned to normal. I learned to deal with the pain and my legs no longer went numb. I was able to function fairly well. Only occasionally did the pain in my back become such that I was unable to function in my “new” normal fashion, and usually only lasted a day or two. I now had added 70 pounds to my weight with no real explanation.

Only in the past couple of years (over 20 have passed since my back injury) have I begun considering the original injury being related to my bowel and stomach problems. Because I believed there was little I could do to rectify the situation, I have done as well as I could to manage the pain mentally. I did this well until the pain in my back started to worsen to the point that again my legs started going numb again. Not that this happened all the time, it was only occasional, but these bouts of pain have gotten much worse.

Only now that the back pain is impossible to ignore have I come to realize the cycle of events which have taken place. Now when I notice my legs are beginning to go numb on a more frequent basis, I have also noticed an increase in my IBS symptoms. More frequent and painful symptoms seem to begin with chronic constipation, lasting for many days. This is followed by the gas distress fatigue, head aches, bloating, acid indigestion, heartburn and eventually explosive diarrhea. Along with other symptoms, all interwoven into a cycle I now believe to be directly related to some type of nerve injury due to my original back injury.

I have since gone to a neurosurgeon and been diagnosed with severe disk compression and degeneration and spinal stenosis in the lower lumbar region. The treatment is as yet to be mapped out, but I now have at least one doctor who agrees that many, if not all, of my symptoms could be tied directly to nerve dysfunction resulting from my present spinal condition.

If you have sustained a back injury, or have IBS with lower back pain, it may be prudent to have a spinal study, to find out if an underlying back problem might be involved in the causation of your IBS symptoms. It stands to practical reason that if there is injury to the spine or lower back from where the nerves controlling lower bowl function stem, there could also be bowel dysfunction. With bowel dysfunction, the progression of symptoms in logical sequence right up the line to the top of the digestive tract would be a very plausible scenario.

If you have IBS and low back pain you really have nothing to lose and everything to gain by having a spinal examination. At the very least you may find out that there is no problem with your spine thereby eliminating one more source.