IBS and useless GP - was I expecting too much?

[OneDayWhenIGrowUp]

Sorry, this has turned out rather long. Just wondering if any other IBS sufferers can help me work out what I can really expect from my GP.

I was diagnosed 6-7 years ago by a previous GP (after blood tests ruled out anything more serious), since then I have not had regular GP care as I have moved around a lot and spent a lot of time abroad too. Generally my symptoms are pretty much constant diarrhoea (sometimes I can get 'normal' stools if I pay close attention to diet and not too stressed), low abdominal pain/urgency in the mornings and sometimes at other times of day too,general abdominal pain/bloating following eating (avoiding wheat and dairy helps though), and occasional constipation, which has led to intermittent rectal tears, and I think maybe haemorrhoid but I don't know (can't see down there!). A rectal tear was diagnosed around 6 years ago and since then I've assumed the same occasional symptoms (usually after a bout of constipation, severe pain on passing, bright red blood on wiping that stops quickly).

Anyway, I self-medicate with over the counter things; I use a lot of buscopan, probably use loperamide 1-2 times a week (when I really can't spend a lot of the day going to the toilet), occasionally (maybe once every 4-6 weeks) need to use bisacodyl to relieve a bout of constipation. Also occasionally I need to use haemorrhoid relief suppositories to be comfortable. I take a daily probiotic. I drink peppermint tea. I try to stick to a wheat-free and low-lactose diet, but I find it quite challenging, as I will also 'get away' with a certain amount before noticing symptoms building up, so I don't really know whats best. Stress definitely makes things worse. When things get too painful I will use co-codamol.

So I have recently settled back in the UK and went to a new GP for the first time in 6 years about my IBS. He was absolutely shockingly useless. He asked what I wanted him to do about it in a very off-hand manner. He said without the notes from my previous GP he did not believe the diagnosis, I asked if he could not make the diagnosis himself after discussing my symptoms and he said no, diagnosis can only be made by a gastroenterologist. (as an aside as I had joined the practice a month previously, been for my new patient 'welcome' check up and registered my NHS number with them I was pretty annoyed they did not already have my old notes). He did not ask me any questions about my symptoms or history, I tried to remember as much as possible to tell him but he did not ask me any further questions at all. I mentioned I had had rectal bleeding recently and he did not examine me, in fact he barely looked up from his computer screen at all (where he was typing the whole time using just two fingers, he was quite elderly). Anyway eventually he gave me a script for 56 buscopan tablets - saves me a little money buying those on prescription rather than the expensive off the shelf ones, although that is only about 3 weeks worth for me, he refused to prescribe any more until he saw my old notes.

Am I being naive in expecting more help? I have got very used to just dealing with my IBS as just part of my everyday life and it doesn't generally stop me from doing anything, as long as I control symptoms well enough with medication. I have become fairly used to just dealing with mild to moderate abdominal pain as normal and just getting on with things. I'm not sure what I was hoping for, but maybe some dietary advice (other than - you should use fybogel - I explained that I had tried that and high fibre made my diarrhoea worse - he actually said, no, it won't do that!! Erm, yes it does, it's my bowel!!), maybe some guidance as to whether I was managing things right, or a referral to a dietician or even a gastroenterologist if that's who he thinks it should be diagnosed by!!!

I don't want to see this GP again as he really was no help whatsoever. Is it worth my time bothering with GPs at all, is there any more help to be had? Would it be worth looking at private healthcare, I do have some kind of plan through my job that may be useful. What care/help/advice do other IBS sufferers get or expect from their GPs?

I think the best thing would be to ask your doctor for a referral to a gastroenterologist.
You cannot plough on with those kinds of symptoms, and need some proper tests done. Good luck!

He sounds dreadful, I would ask to get a referral to a gastroenterologist and check with your work private healthcare policy as you should be able to get seen quite soon.

Your symptoms sound very debilitating and must impact on your quality of life and therefore you must be seen by a specialist and your regime of medication may not be the best or there maybe more they can do

No, he sounds useless. My GP has 'given' me a colposcopy, endoscopy and a CT scan. All clear, so we've narrowed it down to stress and seeing a dietician every so often.

Go back and ask to see a different GP.

Your notes may not have arrived at the practice by the time you saw this GP - and to be honest, with the amount of moving around you've done (did the NHS know that you'd left the country?) they may be difficult to track down. The surgery didn't suggest they'd given you a new NHS number, did they?

I would go back to see a different GP, with a written list of your previous history and medication, so he/she can peruse it later if necessary, and ask to be referred.

Btw, I know someone who has had radiotherapy for cervical cancer who now has IBS-like symptoms, and hers definitely get worse if she eats a high fibre diet.

There's some useful information on NHS Choices and it looks from the Map of Medicine as if your rectal bleeding should have been have a red flag to refer you for investigations.

Nope had the same NHS number since a child and all GPs have had that (I was pretty good at keeping NHS cards to hand in to the next practice).

I'm glad that it's not just me that thought there'd be more help available! I'll make another appointment. It really feels like it shouldn't be such a battle to get good healthcare. Is it acceptable to ask for a referral, is it not something the GP should be suggesting?

You can definitely ask. Where it's something which could arguably be self-managed the choice should be yours - but you should not feel that you have to self-manage, esp with all the medication you're having to take.

However, this battle to get good healthcare is normal, so you should be prepared to hit a wall at every stage. You might be lucky, but after 10 years as a carer for someone with a complex, chronic condition I can tell you it's the norm rather than the exception. Keep pushing.

My DD was given a diagnosis of IBS for 5 years. Because she was at uni, moved area fairly often, was under a lot of stress they just assumed it was IBS. Over the years it got worse and eventually she was referred to a gastro consultant who did a colonoscopy,sigmoidoscopy, scans, blood tests etc and it turned out she had ulcerative colitis. The consultant said IBS should only be diagnosed when investigative tests have ruled out everything else. A blood test alone isn't enough for a diagnosis.

Would definitely get a gastroenterology referral and get the appropriate tests done. It's perfectly in order to say that you've had these symptoms for years, haven't been properly investigated and would like that to be done.

Hello OP, I am suffering with similar symptoms and trying to get doctors attention! Did you have any luck finding out what was wrong?