When your GP isn't helping: A gastroenterologist's guide
by Colm O'Sullivan, on 30/04/21 14:10
Only 17% of respondents to our gut-health survey*, said they found GPs to be beneficial experts to help with their symptoms. Leading gastroenterologist, Dr Simon Smale, explains why this doesn’t surprise him and how patients can take control over their gut health.
The disappointment in GPs suggested by this survey reflects the experience of my patients, who often find the response both from healthcare providers and employers to be inadequate (and sometimes from their own friends and family as well).
Unfortunately, it is rarely possible for GPs - in a 10-minute appointment - to fully explore all the potential triggers and strategies necessary for managing gut issues. While it is vital to see your GP to rule out underlying causes - and to seek the appropriate referrals to help support you - it is ultimately patients themselves who need to take primary responsibility for managing their gut health.
So what can you do to get the help you need when healthcare professionals are short on time and waiting lists are long?
Referrals: A referral to a gastroenterologist with an interest can be very useful but there are too few of us to help every patient. Seeking a referral to a dietitian and/or psychologist – who may have more availability - can often be just as helpful in helping you develop strategies to avoid triggers and manage symptoms. There is, of course, still likely to be a waiting list but there is plenty you can try while you wait.
Research: There’s a wealth of useful information online but make sure to use trusted, evidence-based resources. I’ve created a website to provide useful diet and lifestyle advice with links to useful NHS webinars. When waiting for a referral to psychological services, you could also try the Zemedy app - which uses CBT techniques and NHS-recognised protocols. I also direct people to this gut-health charity website.
Self care: There are no easy answers and no one intervention is going to help everyone but a large cohort of people can be helped by following some key advice:
- Eat regularly: Skipping meals and eating irregularly can disrupt regular gut function and may exacerbate bloating and motility disturbances.
- Identify and avoid triggers: Keeping a food and symptom diary can be a useful to help you identify triggers but don’t ignore other factors such as stress which can play just as big a role in gut issues.
- Take regular exercise and sleep well: NHS guidelines recommend 150 minutes of moderate intensity exercise a week but start where you are and build up the time and intensity gradually. It will hopefully improve your sleep too, which is beneficial for gut health.
- Drink plenty of fluids: Drink at least 8 cups of fluids a day and keep alcohol and caffeine to a minimum. Fizzy drinks and diet drinks are also best avoided as they can sometimes increase bloating.
- Consider a supplement: A good supplement containing beneficial strains of bacteria, such as the unique 35624® culture, may help control symptoms. Specific strains of bacteria perform specific functions, so just because one supplement hasn’t worked for you, doesn’t mean they all won’t.
- Experiment with the amount of fibre in your diet: Try and focus on soluble fibre. It can help keep your bowels regular and boost the beneficial bacteria in your gut. However, some forms of fibre will ferment in the colon and may exacerbate bloating.
- Find strategies to manage stress: When asked, 20% of patients attribute their symptoms to stress and 40% to diet - but if you ask gastroenterologists, they see it the other way around. Try to find ways to switch off (yoga, massage, gardening – whatever works) and if you are unable to access psychological help, the Zemedy app might help.
Remember: no one can live like a monk - it’s about taking small steps in the right direction.
* A survey of 1,000 members of a leading gut health charity, conducted in March 2021, in partnership with PrecisionBiotics®.