Daily Mail

Cost of doctors not taking IBS seriously

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The middle- aged woman sitting in front of me ate exactly the same food every day and could only manage a tiny portion each time. ‘There’s hardly anything that I can eat, doctor,’ she told me.

She was painfully thin and her hair had started to fall out. On the face of it, she had an eating disorder — which was why she’d been sent to see me — but actually it was far more complex than that.

Several years ago, she’d developed crippling stomach pains. After meals she’d become painfully bloated and she’d have diarrhoea several times a day. She had to keep taking days off work and stopped seeing friends.

She’d been to her GP numerous times, and had seen a specialist — but the tests all came back negative. eventually she was given a diagnosis of Irritable Bowel Syndrome (IBS) and discharged from the gastroente­rologist with little more than a leaflet.

‘Maybe cut out food that makes the symptoms worse,’ one doctor had suggested.

SO, Over the months, she tried ‘eliminatio­n diets’ where she cut out more and more foods until she was left with just a handful of things that seemed not to exacerbate her symptoms. This wasn’t healthy but she was scared to start eating properly again.

I have heard the same thing time and time again from patients who have been referred to my clinic.

Many people with IBS develop a fear of food because they haven’t received the right advice.

I was reminded of this particular patient — and countless others like her — by the Mail’s series this week on how to tackle health problems that no one likes to talk about, which included IBS.

No one really likes to talk about their tummy trouble: it can be embarrassi­ng, which means people struggle to go to the doctor with it in the first place. That they then don’t get taken seriously when they finally do seek help is shameful. All too often, IBS is dismissed as being a ‘neurotic’ condition — something just in someone’s head — and therefore not a ‘real illness’.

There a psychologi­cal component with IBS (I’ll get to that), but that doesn’t mean it isn’t having a profound impact on people’s lives. A survey by the IBS Network published last week revealed that more than half of people with IBS say they’ve made career changes to cope with their condition. Two-thirds said it prevented them from participat­ing in hobbies or exercise, and 62 per cent said that it stopped them from being intimate with a partner. IBS can ruin people’s lives — and yet services specialisi­ng in it are few and far between. It is often considered a ‘diagnosis of exclusion’ — meaning doctors diagnose it when all other likely conditions have been ruled out. Symptoms include abdominal cramps, bloating, diarrhoea and constipati­on.

While there’s no clear cause for the condition, it can follow an attack of gastroente­ritis or a course of antibiotic­s. There is also a psychologi­cal element, with symptoms being triggered or exacerbate­d by things such as anxiety or a traumatic event.

Yet people with IBS get quite a raw deal on the NHS, and I often see them in my clinics with severe depression as a result of not being able to get the help they need.

For instance, research has shown that probiotics — essentiall­y a supplement of gut- friendly bacteria — can help with IBS. But this doesn’t mean any old yoghurt that’s stuck ‘probiotic’ on the label is going to work.

A study conducted in 2015 at UCL ran a series of tests on major brands of probiotics to see which of them could actually deliver live, viable bacteria into the gut. Only two of them did: Symprove and VSL#3. The bacteria in the others were killed within minutes of hitting the stomach.

Yet people struggle to get the brands that do work prescribed on the NHS. Psychother­apy, particular­ly CBT (cognitive behavioura­l therapy), and hypnosis have also been shown to be beneficial, although access to both is limited on the NHS.

CBT can help by teaching people how to manage stress — which can make the symptoms worse — as well as improving underlying low mood caused by the impact of IBS. It can also help patients to break the vicious cycle that can develop whereby unpredicta­ble bowel habits can lead to anxiety, and anxiety then leads to further unpredicta­ble bowels.

Given the psychologi­cal torment those with IBS face, you’d think making such therapies more widely available would be a small price for the NHS to pay.

 ?? Picture: SHUTTERSTO­CK ??
Picture: SHUTTERSTO­CK

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