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For more than 17 years, James Lavers was assured by several doctors that the bloating and pain he experienced on and off from his early 20s was irritable bowel syndrome (IBS). His story is far from unique. Gut complaints are extremely common, accounting for one in five GP consultations and millions of over-the counter sales of gastric relief products, for everything from acid reflux and bloating to diarrhoea. And IBS, thought to affect up to 14 million people in the UK, is a very common diagnosis. Yet some experts believe that doctors are too ready to suggest this is the cause of patients symptoms. They argue that there are other conditions, some previously dismissed as hokum (see box below), that could lie at the root of the problem and, ironically, the very treatment patients are given to ease their gut symptoms could make these worse.

City ofUnited kingdomTunbridge wellsSimon smaleKamran rostamiNick boylePeter whorwellManchester universityBritish society of gastroenterologyManchester university hospitalJames laversSouth londonSurgical endoscopyBritish societyEuropean journalClinical investigation