Friday, October 21, 2016

The Seven Mystery Gut Problems Your Doctor May Not Spot

Millions of people in the UK are living with mystery gut problems they struggle to get diagnosed correctly.

They’re often told they have irritable bowel syndrome — for which there’s no specific treatment — but experts believe a significant proportion may actually have other conditions that, unlike IBS, can be tested for and even cured.

That’s the thinking in a new book, co-authored by a leading gastroenterologist, which suggests this misdiagnosis means patients can spend years without treatment — or receiving the wrong treatment, which could make symptoms worse.

Michelle O’Connor was one of those affected. For 22 years she struggled with debilitating gut symptoms.

‘My stomach bloated so much people asked me if I was pregnant, and it was also really painful,’ recalls Michelle, 43, a nurse from Matlock, Derbyshire.

She also had to often rush to the loo because of diarrhoea. Michelle first saw her GP about her symptoms when she was 18, but it proved to be just the first of a series of frustrating experiences.

‘At first I was told that it was irritable bowel syndrome and I should eat more fibre, but this made my symptoms worse.

‘At another stage I was given loperamide pills to control my diarrhoea.

‘On many occasions my GP said my symptoms were down to being “too stressed” and other times he said I was suffering from depression and panic attacks.’

Over the years she had tests for coeliac disease and lactose intolerance, as well as two colonoscopies — where the bowel is examined using a flexible tube with a camera at the end — to check for Crohn’s disease.

She was also tested for overgrowth of candida (a yeast) but the results were negative.

By her mid-20s Michelle’s symptoms had worsened. ‘I worked on a gastroenterology ward and remember thinking that my problems were worse than the patients’.

‘Sometimes I’d have up to ten bouts a day of diarrhoea, including at night. It left me feeling drained.’

Over the next decade Michelle’s long-term relationship broke down — partly because of the stress of her illness.

She also made the difficult decision not to have children ‘because I thought I’d be too ill to look after them’.

Then, three years ago, Michelle’s cousin, a medical sales rep, heard a gastroenterologist speak at a meeting about severe IBS and urged Michelle to seek a referral.

The specialist arranged six tests, including one for bile acid malabsorption (also known as bile acid diarrhoea), a condition that affects up to a million Britons.

It’s caused by an excess of bile acid, which is produced by the liver to break down fats.

The result was positive and Michelle is now having treatment that’s dramatically improved her symptoms.

‘When I found out about how common this condition is I wondered why no one tested me earlier,’ says Michelle, who last year helped set up a charity to raise awareness of the problem.

In fact, this is just one of number of relatively unknown but surprisingly common gut complaints that could be the root cause of mystery symptoms such as bloating and diarrhoea in millions, according to Professor Julian Walters, a consultant gastroenterologist at Imperial College Healthcare in London, and co-author of What’s Up With Your Gut?

‘Bile acid diarrhoea, for instance, is estimated to be the cause of a third of irritable bowel cases where diarrhoea is the predominant symptom,’ he says.

However many patients are not referred early enough for tests and the condition often goes undetected.

One survey of 706 British gastroenterologists found only 6 per cent of patients referred to them with chronic diarrhoea had been tested for bile acid malabsorption as a first-line investigation.

‘I see an endless stream of patients told they had IBS or chronic constipation, for instance, often suffering years of misery with their symptoms but simple tests could pinpoint the real cause,’ says Professor Walters.

‘The problem is they often end up being given treatments that could make their symptoms worse. But with the right treatment, their symptoms often clear up.’

Here we look at seven little-known, but common, gut conditions. Could one of these explain your symptoms?

by The Daily Mail |  Read more:
Image: Getty