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How Am I Doing?

This is a question that IBS patients should be asking themselves, but it may be hard for them to get a yardstick by which to measure their progress. Most of the patients I see are frustrated since, despite lots of diagnostic tests and attempts at treatment by their gastroenterologists, they have not seen the kind of improvement they are looking for.

Rather, I am interested not only in helping these patients, but also in giving them the means by which to measure their progress. We are developing a system with this goal at the Mind Body Digestive Center, and it will be similar to the medical approach I use. What is that? I review my notes from the initial office visit, at the time of a follow-up visit. This is important because when someone lives with a chronic condition from day to day, it may be difficult for them to see progress, because symptoms improve gradually, may go up and down, and the overall pattern may be hard to discern. A review by me after a month or two is more revealing. Doing this helps me not only to see which symptoms have improved, but equally important, to review the symptoms that still require attention and new ideas.

In other GI diseases such as Crohn’s disease, there are established measures of illness but they often involve objective markers such as blood tests, findings on colonoscopy, etc. IBS is different. There are no objective measures, only symptoms. There certainly are IBS symptom questionnaires that yield a symptom severity score and we have used these in our various research studies at the Mind-Body Digestive Center. But they tend to be rather simple and do not allow evaluation of the many dimensions of life that are affected by IBS.

There is now a movement to have patients assess their condition on a fairly regular basis, with the use of the computer and scoring methods. With this approach, the physician can review the patient’s progress on their secure internet page at each visit. Our program at the Mind body Digestive Center will be the first of these programs, and I will describe it in a future blog.

posted on April 12, 2011