A reflection on gut disease over three decades

Similia Vol 31 No 1 – June 2019

Author: Jon Gamble

Abstract

Since I commenced practice in 1987 my observation is that gut disease is becoming worse. By worse I mean that Irritable Bowel Syndrome (IBS) is no longer a relatively benign, yet inconvenient, set of symptoms, but has turned into a far more chronic entity, causing both low-grade inflammation and in some cases systemic symptoms.

In 2006 I published my book on IBS1 in which I described 14 categories or types of that syndrome, each with its different cause. These causes are not mutually exclusive, and complex cases may have more than one. In this article I reflect on what has changed over my time in practice and describe my usual methods of case analysis and prescription.

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