What's that then?
Irritable bowel syndrome with knobs on. In IBS you get pain, diarrhoea, constipation, wind, bloating and you might even pass some mucus...
Do you mind? I'm eating my breakfast.
And then what happens?
You're told all the tests are normal and you've got an irritable bowel. It's very common there are millions like you, it's very miserable but it's not going to kill you. Treating the mind helps for some (hypnotherapy, psychotherapy, relaxation etc) but most doctors go straight for the bowel (fibre for constipation, anti-spasmodic drugs for pain, codeine for severe diarrhoea). Alas, this rarely gives complete relief and many patients end up giving up all drugs, which isn't such a bad thing.
So they're just left to lump it?
Yes. Because it's not a sexy, life-threatening disease, you don't got money pouring in to find a cure.
How about if you relaunched it - with a new name?
Well that's where Dysfunctional Gut Syndrome (DGS) comes in. DGS has been adopted by allergy specialists to describe not just irritable bowel syndrome, but a condition where patients can suffer symptoms all over the body (headaches, impaired memory, nasal discharge, skin rashes, fatigue, tissue swelling, joint and muscle pains, thrush and irritable bladder.) In nearly all sufferers, investigations turn up nothing and most struggle on. But enthusiasts such as Professor Jonathan Brostoff at the Allergy Clinic at Middlesex hospital have found that once identified, a considerable number can be helped with an elimination diet. It's called the Stone Age diet and it's based on the principle that if we ate what our cave-dwelling ancestors did, our guts would be a lot healthier.
So what is in our modern diets that does the damage?
For many, it seems that refined sugars and carbohydrates are the culprits. These are gobbled up by yeast in the bowel, which grow like crazy, wiping out all the good bacteria and mucking up bowel function.
And what's the evidence?
Not conclusive and lots more research needs to be done. However, severe sufferers of DGS have often had protracted courses of antibiotics in the past which are well known to kill good bacteria and promote yeast growth. Also, a Gut Fermentation Test has been developed, on the principle that if you have a lot of yeast on board you do a lot of fermenting. Patients are given a 5g oral glucose load and their blood alcohol and aldehyde levels are measured afterwards.
What, so eating sugar can make these patients drunk?
Perhaps not drunk, but a number have been found to have blood alcohol levels above the legal drink-drive limit without having touched a drop. It's called the auto-brewery syndrome.
I must remember it next time I'm stopped.
But most of the evidence is anecdotal, A lot of patients who've tried the exclusion diet perhaps in conjunction with some anti-fungal drugs, swear by it. Marita Cook, a theatre sister, who I met while filming Trust Me, I'm a Doctor, suffered from tiredness, aches and swelling of the face so severe that her mask couldn't hide it. Now she feels great.
Hang on. There are hundreds of books about the evil of yeast or Candida, all written by flaky people making outrageous claims - are you telling me they're right?
Some of what they say might be right, but they undermine it with unsubstantiated sensationalism. As Prof Brostoff puts it "We each have 30 ft of gut so it's difficult to know what's happening mid-way down there but of the studies that have been done, if you put patients on the right diet, half of them will get better quickly."
And what is the right diet?
To kick out yeast, sugar and refined carbohydrate, you can only eat meat and fish, poultry and game (but not chicken), vegetables (but not potato, tomato and soya) fruit (except citrus) and nuts (except peanuts). You can drink additive free non-citrus fruit drinks, herb and fruit teas. Also in are salt, pepper, herbs, olive or sunflower oil and rice. And for sweeteners, try honey, maple syrup, saccharine or aspartamine. You can kick of with two teaspoons of Epsom salts to get your bad diet out of the way.
What, no cereals, toast and yeast extract?
`Fraid not. And there are plenty of hidden pitfalls, eg preparing food for others or even licking stamps and envelopes can cause contamination. Smoking should be stopped too. Also, when you've been on the diet a while, some people use probiotics (eg live yoghurt) and prebiotics (specialised fibre food) from health food stores to encourage growth of good bacteria. These benefits are probable but not proven.
So not easy at all really?
No. And because you'll need continuing support and encouragement and it has to be monitored closely to prove it works, it's best you try to be referred to a nutritionist or an allergy specialist.
The new series of Trust Me, I'm a Doctor starts tonight, 8pm, BBC2.Reuse content