The Irritable Gut

Abstract

There is a tendency to deprecate functional complaints. Physicians are trained to get to the organic core of a problem and to understand disease in terms of its pathology. When there is no structural or biochemical abnormality, symptoms are difficult to understand. It is easiest to ignore or dismiss that which is not understood. Thus the aim in diagnosis is to identify or exclude pathology. The irritable gut is what is left when no organic explanation for gut symptoms can be found. This negative approach to the diagnosis of functional disease leads to tests and therapy that may be inappropriate and often trivialize patients’ complaints (Figure 10). After all, no one has ever died from an irritable gut.

Epidemics have often been more influentual than statesmen and soldiers in shaping the course of political history, and diseases may color the moods of civilizations.

René Jules Jean Dubos