DR MAX THE MIND DOCTOR: Yes, IBS is tied to the mind, but that’s no reason to dismiss it
While irritable bowel syndrome affects one in five people at some point in their lives and can be debilitating, it is very poorly understood and services specialising in it are few and far between.
IBS is complex. It is a term used to describe a set of unpleasant and wearing symptoms such as bloating, abdominal cramps, diarrhoea and constipation. Often doctors diagnose IBS when all other likely conditions have been ruled out.
While there is no clear cause for IBS, it can follow an attack of gastroenteritis, a course of antibiotics or an upsetting or traumatic event.
We know that the mind and body have a close connection, and many physical health problems have a psychological component — and vice versa. Just because something is partly psychological doesn’t make it any less ‘real’ [File photo]
This seems to disrupt the normal functioning of the gut, causing inflammation and depleting ‘good’ bacteria, which can make it very sensitive.
But there is also a very important psychological component, as stress, anxiety and low mood can all trigger flare-ups.
Though symptoms are often crippling and can dramatically impact people’s lives, many GPs don’t see IBS as a ‘real’ illness and dismiss it as ‘all in the mind’.
So the news this week that a large study — by the University of Southampton, King’s College London and King’s College Hospital in London — has shown that psychotherapy can significantly improve symptoms for sufferers offers real hope.
While this is great news for sufferers and conclusively shows that with the right treatment patients can be helped, there’s still the big hurdle of getting doctors to take the condition seriously [File photo]
The research revealed that patients who were given cognitive behavioural therapy (CBT), a type of talking therapy most commonly used to treat anxiety and depression, fared the best.
The study focused on giving advice about healthy eating, managing stress and challenging ‘unhelpful thoughts’.
Around three-quarters reported a significant improvement in their symptoms, with some having no symptoms at all by the end of the treatment.
While this is great news for sufferers and conclusively shows that with the right treatment patients can be helped, there’s still the big hurdle of getting doctors to take the condition seriously.
We know that the mind and body have a close connection, and many physical health problems have a psychological component — and vice versa. Just because something is partly psychological doesn’t make it any less ‘real’.
For me, this is at the root of the stigma around mental illness — that problems with your mind are somehow less serious or worthy of help and sympathy than problems with your body.
Too many patients are branded ‘neurotic’ and sent out with a leaflet and little else, leaving them to battle the symptoms on their own.
I have seen many patients with IBS who have been referred to my eating disorder clinic because they are dangerously underweight and eating unhealthy diets.
IBS is not a classic eating disorder like anorexia, but many people with it develop a fear of food because they haven’t received the right support or advice.
One middle-aged woman referred to me was incredibly underweight. She ate exactly the same food every day and could manage only a tiny portion each time. Her hair had started to fall out and her skin was blotchy.
The research revealed that patients who were given cognitive behavioural therapy (CBT), a type of talking therapy most commonly used to treat anxiety and depression, fared the best [File photo]
She told me that several years ago she had developed crippling pains in her stomach. She became painfully bloated after meals and had diarrhoea several times a day — which meant she had to keep taking days off work and stopped going out with friends.
All tests came back negative, and eventually she was given a diagnosis of IBS. She was then immediately discharged from the gastroenterologist, with no help or support.
‘Maybe cut out foods that make the symptoms worse’ was the unhelpful advice given to her.
So she tried various ‘elimination diets’, cutting out more and more foods until she was left with just a few that seemed not to exacerbate her symptoms. It was not a healthy diet, but she was scared to start eating properly again.
I have seen this time and time again, and patients often spiral into suicidal depression. Yet much of this could be prevented with proper support — as this new research so clearly shows.
What we need is dedicated, specialist NHS services for IBS around the country which every patient has access to.
I find it astonishing that despite it being such a common and distressing condition, so little is being done to help sufferers.
I’m awed by the power of placebos
The NHS attracted criticism last week when it emerged that it is still spending more than £55,000 a year on homeopathic remedies, despite doctors being told to stop prescribing them.
Within the medical and scientific community, homeopathy — where ailments are treated with minute doses of natural substances — is largely discredited. Yet I think it was a mistake to ban it in the NHS.
Every GP surgery has what are rather cruelly termed ‘heart-sink’ patients — people who keep coming in with multiple, nondescript complaints, who never really get better and who irritate their doctors.
I’m actually in awe of the placebo effect. The fact that we can get better simply because we believe we will is, to me, testament to the astonishing power of the mind [File photo]
Yet it is precisely these patients who so often benefit from homeopathy. Their physical complaints are often manifestations of psychological distress, and sitting with a homeopath, having their problems listened to patiently and being seen holistically, is often what helps them. Now they have nothing.
Homeopathy’s benefits are dismissed by scientists as being down to the placebo effect. Yet the placebo effect works for about 30 per cent of people. So if it helps nearly one in three people, that isn’t bad.
I’m actually in awe of the placebo effect. The fact that we can get better simply because we believe we will is, to me, testament to the astonishing power of the mind.
Those who use homeopathy might believe it’s working in a different way to what the scientific community says, but does that matter? It seems a shame to discount the benefit that some people get from it.
No-sleep braggers are wrong
The likes of Elon Musk and Donald Trump bragging about how little sleep they need are fuelling an epidemic of sleeplessness.
Research from New York this week reveals that those living in the UK and the U.S. are among the most sleep-deprived in the world.
It blames celebrities for fuelling the belief that we need far less sleep than we really do, and perpetuating the myth that getting a good night’s rest is somehow lazy or self-indulgent.
The World Health Organisation says that most people need at least seven hours of sleep a night.
Don’t let anyone tell you otherwise, however famous or successful they may be.
Research from New York this week reveals that those living in the UK and the U.S. are among the most sleep-deprived in the world. The likes of Elon Musk and Donald Trump (above) bragging about how little sleep they need are fuelling an epidemic of sleeplessness
A new antidepressant suitable for depression patients who are resistant to other drugs has just been approved in the U.S. and is being trialled in the UK.
The drug, esketamine, is chemically similar to the horse tranquilliser ketamine and administered via a nasal spray. Most antidepressants work on the brain chemical serotonin but esketamine works on a different one: glutamate.
Advances in science mean that we’re beginning to understand the incredibly complex brain chemistry linked to depression, which is opening up the possibility for entirely new types of antidepressant. Esketamine, which hopefully will be available on the NHS soon, is a real and very welcome breakthrough.
Dr Max prescribes…
After Life on Netflix
Written by and starring Ricky Gervais, this six-part TV series about a man who is suicidal after the death of his wife bowled me over.
It’s billed as a comedy, but is actually a thoughtful study of grief, loss and depression, and the meaning of life.
It will ring true with anyone who has worked in mental health or had to deal with someone who feels hopeless. Despite the bleak subject matter, it’s ultimately life-affirming.
Written by and starring Ricky Gervais (above), this six-part TV series about a man who is suicidal after the death of his wife bowled me over
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