After nearly two years of worsening stomach pain and increased bowel movements, Sam Launder was diagnosed with irritable bowel syndrome (IBS). At 27, he believed it was a condition he would have to manage long-term. However, a year later, doctors discovered a more serious condition that ultimately required the removal of his bowel, including his rectum.
Launder initially attributed his increased bowel movements to an active lifestyle and healthy diet. His symptoms progressed from four to five times a day to six to seven times a day, accompanied by an urgent need to reach a bathroom. He delayed seeking medical attention, suspecting IBS, and upon consulting his general practitioner (GP), he received an IBS diagnosis. He was advised to keep a food diary, avoid fatty and spicy foods, and stay hydrated.
IBS is a common gastrointestinal condition affecting approximately one in five adults in the UK. According to NICE guidelines, diagnosis is symptom-based, with blood and stool tests used to rule out conditions like inflammatory bowel disease (IBD) and celiac disease if red-flag symptoms are present. Professor Anthony Hobson, a gastrointestinal scientist, explains that while abdominal pain is a key symptom, it doesn't exclusively indicate IBS. Bloating, diarrhea, constipation, or alternating bowel habits are also common. Symptoms can sometimes be relieved by a bowel movement and are often exacerbated by certain foods like onions, garlic, dairy, high-sugar fruits, and high-fiber items. GPs typically diagnose IBS without tests unless red flags such as unintentional weight loss, blood in stool, or a family history of colon cancer are present. In such cases, stool tests for inflammatory markers are recommended to exclude IBD and cancer.
As Launder's symptoms intensified, he began to question the IBS diagnosis. He described having to constantly locate bathrooms when going out and avoiding long periods without eating. His concerns led him to return to his doctor, but he was again told he had IBS. Around early 2020, he started experiencing blood in his stool and developed backache. This prompted his GP to refer him for a colonoscopy.
The colonoscopy revealed ulcerative colitis, an inflammatory condition affecting the lining of the large bowel. Crohn's & Colitis UK reports that cases of IBD, including ulcerative colitis and Crohn's disease, are increasing across age groups, particularly among young adults aged 18-29. Researchers suggest environmental factors like diet, low fiber intake, and antibiotic use may contribute to IBD development.
Dr. Rishi Goel, a consultant gastroenterologist, noted that while IBS commonly affects younger individuals, it's crucial to differentiate it from IBD. Ulcerative colitis typically presents with diarrhea, pain, and rectal bleeding, whereas IBS symptoms like bloating and pain do not include bleeding. He highlighted the fecal calprotectin stool test as a valuable tool for distinguishing between IBS and IBD, as IBS does not cause inflammation. Early diagnosis of ulcerative colitis is important to prevent the inflammation from worsening and becoming less responsive to treatment.
For three years, Launder was treated with various medications, including high doses of steroids, which provided some symptom relief but had side effects like weight gain and bone weakening. His condition worsened, with him needing to use the bathroom up to 25 times a day, significantly impacting his social life and forcing him to give up activities like dancing and gym. The steroids caused him to gain weight, increasing his mass from 75kg to 115kg, and resulted in a "moon face" appearance.
Facing severe inflammation and the risk of complications such as severe bleeding or a perforated bowel, Launder's consultant recommended removing his colon. In July 2022, he underwent an eight-hour surgery to remove his colon and was given a permanent stoma, an opening to collect waste. While initially apprehensive, he found relief and a sense of freedom once he adapted to managing the stoma bag.
In July of the following year, Launder had another operation to remove his rectum due to the increased risk of cancer associated with long-term inflammation. This procedure, sometimes referred to as "Barbie butt" surgery, involved stitching the area closed. The recovery was challenging, with significant pain and infections, and took six to nine months to feel like himself again. He expressed heartbreak at not being able to pick up his then-one-year-old daughter during this period.
Now, Launder reports feeling more positive, has returned to the gym, and lost 15kg. He aims to regain strength to be active with his daughter. He hopes his experience encourages others to not ignore symptoms and to persist in seeking answers from medical professionals.
