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Have you seen that wacky story about a woman in Great Britain who was told she had IBS, but really had an enormous ovarian cyst? According BBC News, Janet Delaney's doctor gave her an initial diagnosis of IBS when she first complained of pain. When her pain continued, she made three separate trips to the emergency room before an ultrasound identified the cyst. At that point, the cyst had grown to 17 pounds. Luckily for Ms. Delaney, the cyst was non-cancerous.

This story triggers a variety of thoughts for me. On the one hand, it illustrates the problem with some physicians in that they are not attentive enough to what the patient thinks is the problem. The BBC article quotes Ms. Delaney, "I knew it wasn't just IBS. My mother suffers from that and I didn't have any of the symptoms." Yet her doctor, and those at the hospital, obviously did not pay proper attention.

On the other hand, to be fair, one must acknowledge that sometimes health problems have to develop before they are detectable. A patient that I saw recently had been complaining of twingy pain in her lower left abdomen. As she also suffers from chronin constipation, this seemed like classic IBS. A colonoscopy and an initial ultrasound showed nothing. It was only after several months, that a benign growth on the outside of the vaginal wall showed up on a CAT scan.

The problem here is how do you know when to accept an IBS diagnosis and when to pursue ongoing diagnostic tests? You may recall my discussion of a report that concluded that if you meet the Rome III criteria, there is a 98 percent chance that you have IBS and not something else. Those may be reassuring odds, but some people are going to fall into that other two percent. I guess the best you can do is to try to find a doctor you can trust and listen to your gut (pun intended).


[sub]"Huge cyst woman told she had IBS." BBC News December 15, 2009.[/sub]

[sub]Cash, B., Schoenfeld, P., & Chey, W. "The utility of diagnostic tests in irritable bowel syndrome patients: a systematic review" The American Journal of Gastroenterology 2002 97: 2812-2819.[/sub]

[sub]Spiegel, B. "Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality" IFFGD Digestive Health Matters 17:14-16.[/sub]

Major IBS Misdiagnosis originally appeared on Irritable Bowel Syndrome on Tuesday, December 22nd, 2009 at 05:51:03.

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