Introducing The IBS Self Care Plan
Dr Nick Read, Chair and Medical Adviser, The IBS Network
Irritable Bowel Syndrome (IBS) is the commonest long term illness affecting the bowels. At any one time 10-15% of the UK population suffer from unexplained symptoms of abdominal pain, bloating, constipation or diarrhoea. It may not be life threatening, but it severely reduces quality of life, compromising relationships, causing absenteeism from work and making travel and eating out a nightmare.
Yet there is no definitive cause for IBS. It is a syndrome; a combination of symptoms, for which there may be many different causes. GPs tend to make the diagnosis by excluding other serious conditions that may result in the same symptoms. These may signalled by the presence of ‘red flags’ such as blood in the stool, fever, anaemia or weight loss, but even when these are not present, nowadays GPs can screen for coeliac disease, inflammatory bowel disease and bowel cancer using simple blood or stool tests. This will mean lower referral rates to hospital, but a greater burden of IBS for the busy GP.
People with IBS already complain that their doctor does not have enough time for them, while doctors are frustrated by what they see as the demands of people who do not have a serious disease. It’s a clash of cultures. Attitudes and practice needs to change.
Breaking the mould
IBS is not a disease with specific cause or definitive cure. It is an ‘individual’ illness; the symptoms experienced by people with IBS show a wide variation and include many that appear to emanate from systems and parts of the body other than the gut. These include backache, irritable bladder, headaches, breathlessness, fatigue, muscle pains and many more. It is therefore not surprising that there is considerable overlap between IBS and other chronic, unexplained illnesses like fibromyalgia, chronic fatigue syndrome, migraine and dyspepsia, raising the possibility that all of them are different representations of the same state of mind/body dysphoria. Anxiety and depression are prominent features of all of these conditions.
IBS comes and goes according to a person’s diet and lifestyle and what is happening in their lives. Therefore, for you, the patient, it is important to appreciate context and meaning, what seems to trigger a flare up of your illness and why. With that insight, you are in a much stronger position to work out how to adjust your diet and lifestyle, deal with what happens, self regulate and bring about change.
Knowledge imparts control and informs health confidence. If you understand your illness, then you can learn to manage your symptoms and have a much more effective dialogue with your doctor, nurse, dietitian or counsellor. This is what underpins assisted self management.
The Self Care Plan
Endorsed by health care professional organisations, The IBS Self Care Plan is simple to navigate and uses straightforward text, numerous illustrations, and includes videos, case histories, exercises, links and exercises to create a complete guide, which patients can use to understand and manage their symptoms. It has tabs and sub-menus on diagnosis, diet, stress, medicines and complementary therapies. There is also a section labelled My Symptoms, which contains tabs on the diagnosis, causes and management of diarrhoea, constipation, abdominal pain and bloating. And for IBS Network members, The IBS Self Care plan also includes a unique symptom tracker, by which you can log episodes of increased symptoms and note any associations with changes in diet, exercise, sleep patterns or life events (what has been happening). This record can be collated and printed out to take to your doctor or nurse.
The IBS Self Care Plan is available to everybody free of charge here on The IBS Network website.
But self management is not just a matter of giving people a fact sheet or a website and telling them to get on with it. They also need access to health professionals, trained to facilitate self care using the available information resource. That is why the IBS Network not only provides for its members one to one access to health professionals via telephone and email, but is also applying for funds to train health care professionals in every locality to facilitate IBS self care.
First published November 2013
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