Over the forty years I have had IBS, it has been fascinating to see the changes in approaches toward the condition. For those of us, who have suffered a long time, memories of being told that it was all in the mind will linger.
Once it was finally agreed that in fact IBS was not all ‘in the mind’ some progression was made, and indeed the recommendations for IBS are by and large far better than before.
With that said, have we moved far and fast enough ? Is the syndrome better understood than before ? Or do we kid ourselves into thinking we are progressing ?
Could do better
Before we get too carried away, it is clear that there is still a lot of work to be done. There are also big gaps in the standard of care around the world.
For many IBS sufferers the greatest struggle is that for respect and understanding. IBS sufferers know and understand what IBS is all about, but can the same be said for the general public ?
While the information age has helped IBS sufferers access more and more advice, it has also lead to an explosion of dubious and unhelpful advice.
The volume of information out there, has unquestionably increased however the quality has not kept pace. The net result is that rather than making it easier for sufferers to discover information about the condition, it has become harder and harder to filter the good from the bad.
Having praised the positives it is time to explore the negatives before we can truly conclude just how far we have actually moved forward.
It is patently obvious that there have been significant increases in our knowledge about IBS. It has finally become clear to all that IBS is very much a physical ailment. This is not to say that psychological factors such as stress do not play a part, however the fact remains that there is a physical outcome.
We know more about the digestive system all the time. The sheer volume of IBS sufferers has seen an increase in research and this has given us a clearer picture of the digestive system. In particular there is a greater acknowledgement, if not understanding of the so called ‘brain/gut connection’. The fact that there is a neurological process, occurring in the digestive system, does complicate the issue, however it will enable greater understanding.
We are gaining greater insight into the role of the bacteria. Much is written on this subject, however you have to be cautious with regards to the source if the information, as many are sponsored by companies with vested interests. Despite this, it has become clear that bacteria both friendly and pathogenic play a very large role in IBS. This has lead to the ‘Fecal Transplant’ treatment which is showing very positive signs of success at this early stage.
One of the greatest finds to date has been the Low FODMAP diet. While this is not a cure it is giant step forward in the management of the condition. By IBS standards it has a very high success rate (75%) and more encouragingly this research could yield a lot more information over time. The science has only really been public since 2009, so we can expect further improvement.
While diet alone rarely does enough to manage IBS, it is an area which has shown that while we are all unique there are common trigger foods for IBS, and finally there is an acknowledgement that you need to match your diet to your symptoms. For example, fiber is no longer a great thing for all IBS, it is specifically suited to some IBS, and not others.
There appears to be a greater effort, to find ways to treat IBS. For many years it appeared to be a condition which was devoid of research, marked up as ‘one of those things’. Whether it be stimulated by its fiscal permutations, or the potential rewards, does not really matter. IBS sufferers just want help, and the signs are positive. FODMAP and fecal transplants are just two of many new approaches being pioneered, and while we do not wish to get ahead of ourselves, there appears to be a day where IBS is managed, if not cured in the horizon.
Many IBS sufferers are confronted by Medical Professional who simply do not take the condition seriously. We understand that medical professionals witness some terrible tragedies and regularly come face to face with conditions which we would find hard to comprehend. All we ask is that there is understanding for the level of interference with our lives.
IBS has so few physical signs that it appears very hard for others to sympathise with. The human race at large appears to like a physical sign of illness before we are able to offer our sympathies. However, it is very real, and can be incredibly destructive. Attitudes have improved, but there is still huge room for improvement.
We are getting closer. IBS-c and IBS-d finally start to give an indication of the nature of the symptoms, but the reality is that as a syndrome, IBS is a collection of symptoms all throne in together. Until this is resolved many of the issues regarding attitude will remain unchanged.
This is also so important for the treatment and management of the condition. It remains a mystery, why in this day and age we prefer to simplify this. It surely can not be helpful to the research and discovery of treatments and medication to take such a wide pool of symptoms and group them together based upon there anatomical location alone.
In the seventeenth century an apothecary would have gone to the grave swearing that leaches were a cure for almost any ailment, and the public would have believed them. Today we appear to think we know more than we actually do, and for once it would be breathtakingly refreshing to acknowledge that we have have so much to learn.
Until the bizarre accident involving William Beaumont and Alexis St. Martin, mankind still though that the digestive system was a mechanical process, as opposed to chemical. We know so much more than we did, but we do not know everything. The brain, gut connection, bacteriology, visceral hypersensitivity are all great steps forward, but we are still some way from being in true command of the situation.
We’ve come along way on a journey that still has a very long way to go. There have been great leaps forward, however realistically we are no where near a ‘cure’, nor will we ever be until there are greater classifications of symptoms.