Gut feeling: Getting the right diagnosis

Updated: Jul 21

Misdiagnosis


The path to diagnosis can often take years of many specialist visits and tests, all of which can be frustrating and soul destroying. Meanwhile, you are left suffering with no clear direction of what to do.

Source: Monash University low FODMAP diet

Coeliac disease, inflammatory bowel disease (IBD) (e.g. chron’s disease or ulcerative colitis), Endometriosis, Irritable bowel syndrome (IBS), food allergy or intolerances etc. These are all common conditions which can affect the gut, all of which have overlapping symptoms. This can make diagnosis a difficult task, even to medical health practitioners.


Some of these conditions, if left untreated, will have disastrous consequences for your health (e.g. coeliac disease or IBD), whereas others will be extremely uncomfortable and disruptive, but will not actually cause a decreased life expectancy or cause a significant deterioration in health (e.g. IBS and food intolerances). Therefore, it is vital you receive the right diagnosis to prevent further harm to your health and ease your dis-ease.


Trust your gut. If you feel as though you’re not on the right track, or the treatments and advice you have received is not quite working for you, speak up. Medical practioners try their best to provide you with the right care; however, in some cases they might not completely understand what you are going through from a personal perspective, or they might be treating “the most likely cause” first before they delve into more examinations and tests.


From the doctor’s perspective, they make deductions based on your symptoms starting from the most probable cause, which is a safe approach, but can also cause frustration for the patient. Additionally, they have the nuanced task of identifying people who may be hypervigilant of their health, which in some cases can cause the well-studied nocebo effect (I.e. strong thoughts and beliefs about negative health which can cause negative health effects). A trusting relationship between yourself and your doctor is key to preventing this from happening.


When to get diagnosed


Most of us will go through periods of gut discomfort. It might be some extra bloating, or a bout here and there of diarrhoea or constipation. To a degree these experiences are normal and are of no serious concern.


It can be hard to decide when you should seek help, with many people just accepting their issues as a part of life. However, if you find your everyday function and wellbeing are impacted by your symptoms, then it’s time to go get help.


Look out for red flags

  • Blood in stools or when moving your bowels

  • Sudden unintentional weight loss

  • Waking during the night to move your bowels

  • Nutrient deficiencies that have not improved with supplementation, such as an iron or B12 deficiency

  • Family history of bowel disease

  • Progressive and severe worsening of symptoms

If you have any of these symptoms it is vital you see your general practitioner for testing and/or referral to a gastroenterologist. These symptoms should not be ignored as they can be a sign of a serious health issue which will need medical treatment.


Getting the right diagnosis


Pinpointing the exact cause of your issues cannot be emphasized enough. Depending on the gut disorder or condition, a diagnosis will determine what the best treatment or therapy for you will be, and your prognosis for future health.


When you come to see a dietitian, this diagnosis will be fundamental in helping them provide you with the best possible care for your unique circumstance. It will provide them with the information to determine whether you require a strict gluten free diet, elimination diet, or low FODMAP diet etc; all of which have different nutrition considerations for your health.


If you see an allied health professional like a dietitian without a clear diagnosis, they will often guide you to the appropriate diagnostic path by communicating their recommendations to your doctor.


Tips to getting the correct diagnosis and treatment


Find a GP that listens to your concerns

Your GP is the gateway to receiving medical care. If the doctor you usually see is at a dead end, says “it’s all in your head”, uses an ambiguous explanation like “you’re just stressed”, or is quick to prescribe you a medication without ordering the appropriate tests or specialist referrals, you may need to consider looking for a different GP. Finding the right GP you trust may take some time, but finding one willing to listen and work through your concerns will be worthwhile.


Avoid seeking alternate diagnoses from alternate health practitioners

This can be a controversial topic as many people prefer seeking the help of alternate practitioners, such as naturopaths or osteopaths, as their approach is seen to be gentler and more natural. However, when your diagnosis is in question, this can be a very risky option as most alternate health practitioners do not have the tools or training to be able to provide you with a medically accurate diagnosis, despite claims often made. This can send you down multiple treatment paths which can delay correct diagnosis, and treatment. Also be wary if an alternate health practitioner is reluctant to communicate with your doctor or medical team, as a collaboration of care is most often needed.


Be wary of non-validated tests

There are a plethora of health tests offered on the market that can be misleading and delay proper diagnosis, a common one being the IgG test for food intolerances. Always go through a GP or medical specialist who can order the correct evidence-based tests which are almost always subsidised by Medicare. They will be able to interpret the results, your clinical history, and refer onto a specialist as needed.


Work closely with the healthcare professionals you trust

We see the best health outcomes when you are under the care of a well-communicating multidisciplinary team. These teams should include (depending on your unique circumstances) your GP, a gastroenterologist, psychologist, dietitian, or physiotherapist, to name a few. When you have a well-oiled multidisciplinary team you will know your condition is being treated in a holistic, evidence-based manner.


Have patience, sometimes the journey to diagnosis can be arduous and full of obstacles. With the right medical professionals, you will be on your way to improved quality of life and better long-term health.

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Nutrition in Mind | 2019 | ABN 67 347 447 833

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