“In recent years, researchers have drawn attention to the link between gastric health and general health, with regard to cardio-vascular diseases, for example. It has also become fashionable to consume probiotics to improve the intestinal flora. The gut is no longer seen as a waste management station, but as an important part of the body!” says Bodil Ohlsson. She is a professor of internal medicine who has long been conducting research into the diseases of the digestive tract.
If doctors cannot find a medical reason for the gastric problems of a patient, they diagnose IBS, Inflammatory Bowel Syndrome. This is what is irreverently referred to by medics as a “wastebasket diagnosis” – a label applied when no one really knows what is wrong.
The patients’ treatment primarily focuses on changes to their diet and suitable exercise. Low doses of antidepressive medication can help with the pain, and in severe cases hypnosis, mindfulness and cognitive behavioural therapy can also be used.
However, more specific treatment may be available in the future. Bodil Ohlsson believes that IBS is not one single disease, but several distinct conditions which should be treated in different ways. This is already the case with gluten intolerance and microscopic colitis, two diseases which were included in the IBS diagnosis until physicians learned to recognise their particular characteristics.
Bodil Ohlsson is therefore currently researching new ways of examining IBS patients. She hopes that genetic markers, MR-imaging of intestinal mobility and new ways of obtaining tissue samples can facilitate the division of patients into separate groups which can be given different treatments.
Another useful research method is to study different hormones and how they affect the intestine. Thanks to research such as Bodil Ohlsson’s, we currently know that excessive amounts of a hormone known as GnRH, gonadotropin-releasing hormone, are damaging to the intestine.
GnRH is used for in vitro fertilisation (IVF) and to treat the gynaecological disease endometriosis. Women who are given such hormonal supplements have shown to have more problems with abdominal pain than other women.
Endometriosis is a disease which requires treatment, and the desire to have children is a strong urge. So Bodil Ohlsson does not advocate abandoning the use of the hormone. But it should be administered in the lowest possible doses, and women who are to undergo IVF should be aware of the risks.
“They could perhaps consider adoption instead? Or be satisfied with only one or two children, as the risk of digestive problems seems to increase with the number of hormonal treatments.”
GnRH affects the ovaries, the uterus and the intestine because all these organs have receptors capable of picking up the hormone. Therefore, if a woman receives high doses of the hormone, its effects are not limited to the ovaries, which are the intended target in view of IVF, but also involve the intestine, where they can be damaging.
From a medical point of view, IBS is not a serious illness, but it can strongly affect the lives of patients.
“Studies of people’s quality of life have shown that IBS patients actually suffer as much as cancer patients”, says Bodil Ohlsson.
If you always need to be within reach of a lavatory, often have to rush out of a meeting or a dinner when your gut is playing up, constantly have abdominal pain and don’t fit into your clothes because of bloating, it is hardly surprising that your quality of life is affected. In addition, these problems are not always taken seriously.
“One of my doctoral students showed in a study that the most important thing of all was to confirm the patient’s perception of the problem. If patients are met with the attitude that this is nothing to worry about, their situation becomes even more difficult”, says Bodil Ohlsson.
Recurrent gastric problems occur in both young people and the elderly, in women and men. This emerges from broad public health surveys. However, those who seek help for their problems are mostly women and young people.
That IBS is therefore considered a female disease is one reason for its low status. The location of the disease in the intestines and the stomach – organs which are seen as necessary but not particularly appealing and even a little disgusting – is another reason.
“But as mentioned earlier, there are signs of improvement. Within the research community, intestinal problems are taken more seriously today, and the popular science book Gut – The Inside Story of our Body’s Most Underrated Organ was last year’s best-selling non-fiction book in Sweden. So I believe our patients can get better care in the future”, says Bodil Ohlsson.
Text: Ingela Björck
Photo: Gunnar Menander
