Sam Launder experienced worsening stomach pain and an increasing frequency of bowel movements for nearly two years before being diagnosed with Irritable Bowel Syndrome (IBS). At 27, he believed this was a condition he would have to manage long-term. However, a year later, doctors discovered a more serious condition that necessitated the removal of his bowel, including his rectum.
Initially, Launder's symptoms involved four to five bowel movements daily, which he attributed to his active lifestyle and healthy diet. As a restaurant assistant manager, he was fit, went to the gym regularly, and competed in ballroom and Latin dance. The frequency gradually increased to six to seven times a day, accompanied by a growing urgency.
He delayed seeking medical advice, suspecting IBS, but after several months, he consulted a doctor. He was diagnosed with IBS and advised to keep a food diary, avoid fatty and spicy foods, and stay hydrated. IBS is a common gastrointestinal condition affecting approximately 15 percent of adults in the US, according to the American Medical Association. Diagnosis typically relies on symptom assessment, with doctors ruling out conditions like inflammatory bowel disease (IBD) and celiac disease through blood and stool tests.
Professor Anthony Hobson, a gastrointestinal scientist, explains that IBS is characterized by abdominal pain, often accompanied by bloating, diarrhea, constipation, or alternating bowel habits. Symptoms can be exacerbated by certain foods and may or may not be relieved by a bowel movement. Doctors may diagnose IBS without specific tests unless "red flags" are present, such as unintentional weight loss, blood in stool, a family history of colon cancer, or new symptoms in individuals over 45. These red flags may prompt further investigation with stool tests to check for inflammatory markers.
As Launder's symptoms intensified, he began to doubt the IBS diagnosis. He recalls needing to know the location of bathrooms when going out and carrying a change of clothes due to fear of accidents. His concerns grew when his symptoms seemed more severe than what he read about IBS online, leading him to return to his doctor, who reiterated the IBS diagnosis.
In early 2020, approximately a year after his initial diagnosis, Launder began experiencing rectal bleeding and backache. This led to a referral for a colonoscopy, which revealed he had ulcerative colitis. Ulcerative colitis causes inflammation and painful ulcers in the lining of the large bowel, believed to be an autoimmune response where the body mistakenly attacks its own bowel lining.
A recent study indicates a rise in IBD cases, including ulcerative colitis and Crohn's disease, particularly among younger populations in the US, with an estimated 100,000 individuals under 20 affected. Researchers suggest that environmental factors like diet, low fiber intake, and antibiotic use might influence the immune system and gut bacteria balance, potentially contributing to IBD development.
Dr. Rishi Goel, a consultant gastroenterologist, notes that ulcerative colitis typically presents with diarrhea, pain, and rectal bleeding, distinguishing it from IBS, which usually involves bloating, pain, and changes in bowel habit but not bleeding. He highlights that distinguishing between the two conditions can be challenging due to overlapping symptoms.
A fecal calprotectin stool test, which detects a protein signaling bowel inflammation, is particularly useful in differentiating IBS from ulcerative colitis and other IBDs. Dr. Goel advises considering this test for patients with IBS-like symptoms, as IBS does not cause inflammation. A negative result makes IBD less likely but does not entirely rule it out. He warns that delaying diagnosis of ulcerative colitis can lead to more severe inflammation and reduced treatment effectiveness.
For three years after his ulcerative colitis diagnosis, Launder underwent various treatments, including high doses of steroids, which provided some symptom relief but carried significant long-term risks like weight gain and bone weakening. At his worst, he required up to 25 daily bathroom trips, impacting his social life and leading him to quit dancing and gym activities. The steroids caused him to gain considerable weight, from approximately 165 lbs to 253 lbs.
Ultimately, the inflammation became so severe that doctors recommended removing his colon to prevent serious complications. In July 2022, Launder underwent an eight-hour surgery to remove his colon and was given a permanent stoma, an external pouch to collect waste. While initially hesitant, he found relief and a sense of freedom from not having to constantly worry about bathroom access.
In July of the following year, he had another operation to remove his rectum due to the increased risk of cancer associated with long-term inflammation. This procedure, known as 'Barbie butt' surgery, involved closing the area. The recovery was challenging, with restrictions on sitting and experiencing infections and bag leaks. It took six to nine months to begin feeling like himself again. He expressed the difficulty of not being able to hold his young daughter during his recovery.
Launder is now feeling more positive, has returned to the gym, and has lost about 33 lbs. He aims to regain strength to be active with his daughter. He hopes his story will encourage others not to ignore concerning symptoms and to persistently seek answers from healthcare providers.
