Disorders of gut-brain interaction: Highly prevalent and burdensome yet under-taught within medical education 2022 Simons et al

Abstract

Background
Despite their high prevalence and burden, disorders of gut-brain interaction (DGBI) are undertaught and underrepresented in medical curricula. We evaluated the exposure of UK gastroenterology trainees to DGBI and their comfort managing these conditions.

Methods
An electronic survey was distributed to trainees via UK training program directors. The survey included questions on stage of training; subspecialty interest; access to DGBI training opportunities, and comfort levels with DGBI diagnosis and management. Responses were compared between junior and senior trainees, by subspecialty interest (luminal and non-luminal), by geographical region, and training program size.

Key Results
One hundred twelve trainees from across the UK participated (21.4% of national training post holders). Exposure to DGBI lectures (32.8% junior vs. 73.3% senior trainees, p = 0.00003) and clinics (9.0% junior vs. 42.2% senior trainees, p = 0.00003), increased with seniority. Regardless of seniority, most trainees were rarely comfortable making a DGBI diagnosis (39.5% senior vs. 33.9% junior trainees, p = 0.69), and were not comfortable initiating neuromodulators (50% senior vs. 25.8% junior trainees, p = 0.08). Trainees without a luminal subspecialty interest (50%) accessed fewer DGBI clinics (p = 0.04), had less communication skills training (p = 0.04) and were less likely to have been observed during DGBI consultations (p = 0.002). Responses were similar across UK regions and did not differ between smaller and larger programs.

Conclusions & Inferences
DGBI training opportunities are limited in UK gastroenterology training across training grades. Most trainees lack confidence with DGBI diagnosis and management. Urgent interventions need to be targeted at all stages of training to ensure DGBI competencies for future gastroenterologists and improve patient outcomes.

Open access, https://onlinelibrary.wiley.com/doi/full/10.1002/ueg2.12271

 

I am glad to hear it but concerned it is only 255 for juniors.
Since when did we know enough to prescribe neuromodulators for 'DGBI'.
This is the FND story all over again it seems.

 

That triggers my suspicious aspect. I wonder if that translates as "(Big Pharma) needs to push their drugs for this undertapped market."

 

I think they are out to save money for the health service. They seem very clear they will try anything without good proven evidence. They also associate non-GI symptoms of this with somatisation (which is a psychiatric term they are now throwing around like confetti!). So add a few symptoms from other systems and you are a somatiser. Odds ratio 6.9, the highest in this infometric

there is quite a list of what they consider DGBI. functional dysphagia, functional dyspepsia, functional heart burn, functional chest pain, functional bloating, functional diarrhoea and the catch all diagnosis: unspecified functional bowel disorder

 

Lol. DGBI (Doctor Generated Bullshit Ideology) affects 1-in-3 adults across Great Britain.

At some point they're going to have to simply claim that the entire population (apart from doctors, natch) has functional neurologic / whatever disorder. Presumably when a doctor then gets such a condition or set of symptoms, they can no longer be regarded as a doctor.

This seems to be the approach taken by Reddit's r/medicine, where from my limited experience if you even slightly mention you have lived experience as a prelude to discussing actual science, your post will be quickly deleted. Contrast where some member of the great unwashed, ie lay public - but also apparently nurses - comment from a similar framing, their post is not deleted. Can't be having a non-conformist priesthood doctors.