The Inside Story
The IBS Health Professional Bulletin
How Does The Busy GP Manage IBS?
Since GPs have had to manage the budget for the health care of their patients, there has been increased pressure on them to limit unnecessary referrals to secondary care and to find inexpensive options for treating common conditions. IBS is a medically unexplained illness that affects about 15% of people in the UK. The symptoms are non specific and can be generated by any condition that affects or irritates the bowel, including most commonly stress and diet (food and mood). Thus, with an illness that is more an expression of the individual than a discrete pathological process, how can the busy GP understand the patient and restore health confidence in a ten minute appointment? Who better to ask than Dr Marion Sloan, a busy GP Partner with special interest in women's health and gastroenterology and a member of the Sheffield CCG.
What's new...
Some abstracts from the BSG in Manchester
1. A quarter of patients with diarrhoea and IBS have Bile Acid Malabsorption (BAM).
BAM is common in IBS-D, but is this a primary defect in bile acid transport or just secondary to rapid small bowel transit?
Read More2. Mesalazine confers no benefit for diarrhoea predominant IBS.
Diarrhoea in IBS is associated with low grade inflammation of the colon, but a multicentre study of treatment with anti-inflammatories failed to show any benefit.
Read More3. Using Faecal Calprotectin (FC) to screen for IBD can save on unnecessary colonoscopies.
FC prevented 71% of possible colonoscopies in patients with altered bowel habit where there was a diagnostic dilemma, allowing earlier diagnosis while saving substantial expenditure and reducing endoscopy waiting times.
Read More4. GPs have little faith in Rome Criteria to diagnose IBS.
Most GPs regard IBS as a diagnosis of exclusion and less than 10% used the Rome Criteria. 80% screened for coeliac disease using serology.
Read More5. The Cost of IBS in England.
Analysis of Hospital Episode Statistics (HES) data for 2012 - 13 for all the Care Commissioning Groups (CCGs) in England indicated that diagnostic exclusion of other conditions amounted to a total cost of around £180 million while treatment with laxatives and antispasmodics cost over £50 million.
Read MoreSome key papers
1. Does IBS run in families?
A large scale population study in Sweden showed that the association of IBS was statistically significant in first degree relatives and also in spouses of patients with IBS, suggesting the importance of shared environmental influences as well as possibly genetics.
Read More2. IBS is more common in overweight and obese children
Nearly half of obese/overweight children had a functional bowel disorder compared with a quarter of normal weight children, but only a third of them sought medical help. Phatak and Pashander. International Journal of Obesity (2 May 2014) | doi:10.1038/ijo.2014.67.
Read More3. Breath tests overestimate small intestinal bacterial overgrowth (SIBO) in patients with IBS.
Small intestinal aspirate and culture revealed that about 19% of patients with IBS, most of them with diarrhoea, had SIBO but results of breath tests showed a very poor correlation, suggesting that diagnostic performance of these tests are inadequate to diagnose SIBO, which is less common than has been previously reported.
Read MoreRecent reviews
1. Collins, S. M. (2014). A role for the gut microbiota in IBS. Nature Reviews Gastroenterology & Hepatology.
Read More2. Cash, B. D. (2014). Emerging role of probiotics and antimicrobials in the management of irritable bowel syndrome. Current Medical Research & Opinion, (0), 1-11
Read MoreHow would you respond to this question from one of our members?
I am now 58 and since going through the menopause a few years ago, my diarrhoea/ IBS has become much better (after more than 30 years of pretty hellish and constant symptoms). However because hot flushes, sweats and fatigue were bad my doctor advised that I should try a low dose of HRT, which I've now been on for about 9 months. During this 9 months I've noticed my IBS slowly returning and I'm just starting to panic... the thought of going back to never being able to go out for a meal, losing friends and my social life again, fills me with despair. Is it likely that it is the HRT causing the problem? I am taking it in the form of an Estrogen/progesterone patch which I cut in half. I can't be sure that the HRT is the cause and I don't want to stop taking it if this is unrelated.
Please send your ideas to info@theibsnetwork.org with The Inside Story as the subject.
Calendar
A look at our upcoming events
Gut Week: 11th - 17th August
The Love Your Gut partners, Yakult UK, Core and The IBS Network are again hosting Gut Week For more information, click here
James Freston Conference: 16th - 17th August, Chicago, Illinois
Chicago's James Freston Conference 2014 will focus on Therapeutic Innovations in Microbiome Research and Technology: Faecal Microbiota Transplantation. For more information click here
Gastroenterology and Nutrition Meeting: 12th September, Charles Hastings Centre at Worcester Hospital.
A Third Meeting of Gastroenterology and Nutrition is taking place at the Charles Hastings Centre at Worcester Hospital on 12th September. There is a specialist session on Irritable Bowel Syndrome featuring Professor Robin Spiller on mechanisms and treatment and Marianne Williams on Diet. Download Flyer
British Society of Gastroenterology Annual Meeting: 14th - 16th September, Xian, China.
And while you're around and about, why not go to China? The second world conference on Controversies in Gastroenterology is taking place in Xian, China and features a session on 'IBS is an inflammatory disorder'.
Gastroenterology Symposium: 19th September, Royal Victoria Holiday Inn, Sheffield
The Sixth Annual Sheffield Gastroenterology Symposium will feature a session on IBS vs IBD in which Dr Alex Ford will speak on IBS; which test should I perform?
Course on childhood constipation: 30th September, Academy of Paediatric Gastroenterology, University College London.
A course on childhood constipation at the Academy of Paediatric Gastroenterology at University College London features guest speaker, paediatric gastroenterologist, Dr Mark Benninga. For more information click here
Who we are
The IBS Network is the UK's national charity for IBS, offering information, advice and support to patients with IBS and working with health care professionals to facilitate IBS self management.
For more information and to visit our Self Care Plan go to our website.
The IBS Network, Unit 1.12. SOAR Works, 14 Knutton Road, Sheffield, S5 9NU.
Tel: 0114 272 3253 Email: info@theibsnetwork.org Web: www.theibsnetwork.org
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