I have just read the summary of a paper published in the Lancet last year and I think it bares consideration on these pages.
I only have access to the summary as the paper is over 30 bucks but it highlights both the difficulty separating the diagnosis of IBS from more 'profound' disease, and, in my mind at least, highlights the need to have these major illnesses considered and then dismissed, in the first instance!
I like many floundered around while I was trying to diagnose my condition and looking back there were few who mentioned or even tested for 'red line' disease like bowel cancer or IBD.
Nutritionists and alternate medicine practitioners are a mix bag of advisers. Make sure you have dispelled the possibility of major disease before embarking on their program of diet and supplementation!
Irritable bowel syndrome (IBS) is a common functional bowel disorder characterised by symptoms of recurrent abdominal pain associated with a change in bowel habit. This condition is one of the most frequent reasons to seek a gastroenterology consultation in primary and secondary care. The diagnosis of IBS is made by identifying characteristic symptoms, as defined by the Rome criteria, and excluding organic gastrointestinal diseases that might otherwise explain these symptoms. Organic conditions that can be mistaken for IBS include coeliac disease, inflammatory bowel disease (IBD), colorectal cancer, and, in those with diarrhoea-predominant symptoms, chronic gastrointestinal infections, microscopic colitis, and primary bile acid diarrhoea. The concept of small intestinal bacterial overgrowth being associated with IBS is shrouded with controversy and uncertainty, mainly because of invalid tests due to poor sensitivity and specificity, potentially leading to incorrect assumptions. There is insufficient evidence to link IBS-type symptoms with exocrine pancreatic insufficiency or with symptomatic uncomplicated diverticular disease, since both are hampered by conflicting data. Finally, there is growing appreciation that IBS can present in patients with known but stable organic gastrointestinal diseases, such as quiescent IBD or coeliac disease. Recognising functional gut symptoms in these individuals is paramount so that potentially harmful escalations in immunosuppressive therapy can be avoided and attention can be focused on addressing disorders of gut–brain interaction. This Review endeavours to aid clinicians who practise adult gastroenterology in recognising the potential overlap between IBS and organic gastrointestinal diseases and highlights areas in need of further research and clarity.
Thank you for this David and it looks like you've been studying hard.
This is a very good post and can be a little worrying as some people have doctors that can be too dismissive and just say it's IBS without carrying out or referring people for tests. Fortunately I have a very good surgery so had an Endoscopy, Colonoscopy, blood tests and an Ultrasound.
Thank you very much for sharing.
Alicia🙏😊
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Hi Alicia
My pleasure, just trying to keep my finger on the pulse...or maybe that should be on the Microbiome! 🙂
Hope alls well,
David
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It was great to see a post from you as I've no doubt you've been studying hard.
I'm doing really well thank you David, I'm taking Alflorex and they helped a lot and mean I can eat some high fodmap food.
Hope all's good with you.👍😊
Alicia🙏
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Good to hear you are doing well. Me, busy busy... 😄
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Thank you David and starting the low fodmap diet was the best thing I ever did, would you believe it was a year ago yesterday that I actually started the diet, where has that gone. I thought you'd be very busy, you're not one to be bored
in reply to
less gut, more photography these days!😊📸
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Can't beat photography, a lovely hobby. 🌈😊
I was sent away with buscopan and suffered over a year from ibs symptoms before a different doctor tested for h pylori and it was positive
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I hope you are feeling better now Hidden
This just goes to show that many doctors do not have the correct protocols in place. When a test cannot be used to determine a patient's condition then it should be incumbent on them to check for 'red line' conditions.
Helicobacter pylori is an unpleasant bacteria if left unchecked (as I am sure you know!) as it penetrates the stomach mucoid lining and contributes to leaky gut.
Your experience mimics many on this portal. I was tested only for H. pylori and when it came back negative my GP booked me in for a phycology consultation. I 'politely' refused and went on a search for expertise elsewhere! Fortunately I had the resources to do so, many don't, sadly!!
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Much better now thanks. But they don’t tell it can take 6 mths for the symptoms to completely go 😳
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Good news!
They don’t tell you because they often don’t know! Most GP’s and many specialists only receive a few hours on nutrition/diet during there training, often from years ago. Your pylori was probably food born.
Thankfully there is a move towards lifestyle medicine, even in the mainstream. Better late than never I guess!
Estimates vary but conservatively 70% of all serious disease is lifestyle driven, and of that diet is often the biggest contributor...along with smoking and drinking of course.
The sooner medicine moves away from disease management to wellness promotion the better! The US is estimated to spend $3.5 trillion on such ‘management’ and its increasing. The healthcare system will probably be unsustainable in 10 years.
And we are not that far behind! Our Heath system is creaking and Covid has highlighted the inadequacies. People have very sadly died because of lifestyle conditions like being overweight or having type 2 diabetes. Both wholly reversible with diet!
Sorry I’ve robbed your post for my rant! 😊
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No I agree. I don’t smoke I do like a beer but try to limit this to weekends. I did swim but the government have shut all the pools and gyms! LolI’m sure there’s something out there to get us all you can do I’d make small changes as you go, big changes will probably fail like some many New Years resolutions I suppose
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