At the Avicenne hospital in Bobigny, an original system for treating irritable bowel syndrome

Gilles (first name has been changed), a patient suffering from irritable bowel syndrome, shows the medications he has taken for four years: none relieves his pain.  At the Avicenne hospital, in Bobigny (Seine-Saint-Denis), July 11, 2023.

One by one, Gilles (all the patients’ first names have been changed) takes out the boxes of medications he has used over the past four years. “I tried that, but it doesn’t do anything for me either. » In total, more than ten packages pile up on the gastroenterologist’s desk Fabien Wuestenberghs, at the Avicenne hospital in Bobigny (AP-HP), who carefully examines the medical records of this 49 year old mechanic. Or a thick binder containing the results of at least two colonoscopies, an intestinal biopsy, an abdominal scanner, a positron emission scanner (PET-scan) and a whole battery of various exams. None show any organic abnormality or inflammation.

Gilles suffers from irritable bowel syndrome (IBS), also known a few years ago as “irritable bowel syndrome” or “functional colopathy”. An elusive evil, which affects 5% to 10% of the population, according to various scientific studies, or more than 3 million people in France. This patient’s symptoms alternate between diarrhea and constipation, but above all permanent pain in the stomach, back and pelvic cavity, as well as heartburn, flatulence and “slamming intestines”. “Out of twenty-four hours, I have pain for twenty hourssums up, fatalistically, the Oise mechanic. I don’t want to do anything anymore, I’m constantly tired, I’m no longer hungry. » Since the onset of symptoms in 2019, he has lost 15 kilos.

After multiplying general medicine and gastroenterology consultations for four years, without any improvement in his condition, he decided to make an appointment at the day hospital for people suffering from this disease set up there. six months ago in the premises of the Avicenne hospital in Bobigny (Seine-Saint-Denis). Two days a week, patients are seen successively by a gastroenterologist, a dietician and a psychologist. At the end of the day, the three health professionals meet and propose several options theutic to the patient. “This allows us to have a global vision of each case”underlines Jean-Marc Sabaté, gastroenterologist operating this device, which is still rare in France.

Fabien Wuestengerghs, gastroenterologist, receives Gilles (first name has been changed) in consultation, at the Avicenne hospital, in Bobigny (Seine-Saint-Denis), on July 11, 2023.

Adaptation of diet

The same day two other patients were received. Mathilde, a young, dapper 26-year-old blonde, has suffered from digestive problems since birth and “knows how to manage, since she grew up with it”, despite a medical wandering of around fifteen years. The young woman, who does not eat in the evening and takes a Smecta before meetings that are too long to avoid unpleasant surprises, is eager to test a new treatment, ondansetron, a drug indicated during certain chemotherapies to prevent nausea. and vomiting. Jean-Marc Sabaté uses it for repositioning for IBS, although no indication has yet been validated in this context.

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