THE British Society of Gastroenterology has just published guidelines on the management of irritable bowel syndrome (IBS), which is defined as abdominal pain with altered bowel habits for at least six months - where there are no 'alarm symptoms'.
This is key. Such symptoms include unexplained weight loss, rectal bleeding and iron-deficiency anaemia.
What worries me about this is that the loss of continuity of care - seeing the same GP - and the push for more care to be conducted online or by text, means that assessing these 'alarm symptoms' (and arranging tests) is difficult, to say the least.
Patients with potentially sinister disorders are more likely to be missed, falsely concluded as having IBS when perhaps they have coeliac disease, gallstones or even bowel cancer.
All patients with ill-defined abdominal symptoms, and we see them every day, require not just a conversation ('the history') but a physical examination and other investigations in order to reach that point of dismissal of other possibilities.
But how many people with abdominal pain and an altered bowel habit are going to undergo such detailed essential assessment?
An online diagnosis worries me.
© Daily Mail
