Normal or diseased? Navigating indeterminate gut behaviour

Christina McKerchar; Lee Thompson; Susan Bidwell; Aaron Hapuku

doi:10.1071/HC23090

RESEARCH ARTICLE (Open Access)

Previous Next Contents Vol 15(4)

Normal or diseased? Navigating indeterminate gut behaviour

Christina McKerchar

¹ ^* , Lee Thompson ¹ , Susan Bidwell ¹ , Aaron Hapuku ²

+ Author Affiliations

- Author Affiliations

¹ Department of Population Health, University of Otago, Christchurch, 34 Gloucester Street, Christchurch, New Zealand.

² School of Health Sciences, University of Canterbury, New Zealand.

^* Correspondence to: christina.mckerchar@otago.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care 15(4) 350-357 https://doi.org/10.1071/HC23090

Submitted: 15 August 2023 Accepted: 10 November 2023 Published: 7 December 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

Delayed diagnosis of gut disease is a continuing problem, variously attributed to a range of patient, doctor, and health system factors. Gut disease often begins with indeterminate gut behaviours that are hard to classify.

Aim

This study aimed to investigate delayed diagnosis from the point of view of the patient, or prospective patient. How gut and gut disease was understood, what might prompt them to seek care, and their experiences of seeking care.

Methods

Using a qualitative design, we interviewed 44 people in New Zealand. Thirty-three had a diagnosis of gut disease, and 11 did not, though some of the patients in this latter group had symptoms.

Results

Some participants had a smooth trajectory from first noticing gut symptoms to diagnosis. However, a subgroup of 22 participants experienced long periods of troublesome gut behaviours without a diagnosis. For this subgroup of 22 participants, we found people struggled to work out what was normal, thus influencing when they sought health care. Once they sought health care, experiences of that care could be frustrating, and achieving a diagnosis protracted. Some who remained undiagnosed felt abandoned, though had developed strategies to self-manage.

Discussion

Indeterminate gut behaviours remain complex to deal with and it can difficult for both patients and doctors to assess when a symptom or group of symptoms need further investigation, watchful waiting or the use of other supportive strategies. Effectively communicating with healthcare staff can be a significant problem and there is currently a gap in support for patients in this regard.

Keywords: patient journey, primary health care, qualitative trials.

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