Readers of this blog already know that I am fascinated by IBS. It is both a diagnostic and treatment challenge of the highest order. It is clearly a condition in which mind and body interact to produce a myriad of distressing symptoms. It causes enormous suffering.
In many ways it is difficult to diagnosis, for certain. There is no biopsy or single blood test which will make the diagnosis. It also can manifest itself in a variety of forms. It can share signs and symptoms with other more "serious" conditions in which therapy is very different.
There are attempts to make the diagnosis more scientific. Prometheus is a pharmaceutical and testing company which launched an IBS diagnostic panel of lab tests in an attempt to rule in or rule out IBS.
They are a fascinating complex combination of ten assays whose names themselves might trigger an IBS attack. Forgive me if I list their names. For the sake of brevity I will not explain what each is supposed to reveal.
Trust me that the names of each assay seems foreign even to me. Several reflect activity consistent with IBD which is inflammatory bowel disease (ulcerative colitis & Crohn's disease), others suggest celiac disease. The remaining suggest immune dysfunction or motility disorders.
The problem with this approach is that although it may confirm the diagnosis, it doesn't lead to therapy, to healing.
This is the challenge of treating IBS in the real world.
It still comes down to tailoring the treatment that works for the individual who sits before me, behind the exam room door.