Description
How often are you seeing patients with substantial debilitating gut dysfunction that’s been labelled IBS but remains refractory to everything that ‘should help’? In these scenarios it’s not uncommon for us to feel we need to bring out the ‘big tests’ in order to find that elusive exotic diagnosis that everyone else has been missing. But is that always correct? The case I present had decades of diarrhoea, dozens of investigations and yet she presented with chronic diarrhoea even on a heavily restricted test. There’s no test that will tell you her diagnosis – but correct application of your core case taking skills and an integrative work-up will. Likewise the salves and solutions for this are well within our scope.
