Novel management of symptoms in patients with irritable bowel syndrome
Irritable bowel syndrome (IBS) affects up to one in five people in the UK, often causing persistent tummy pain and loose stools. Standard NHS care follows national guidelines using basic blood tests and lifestyle advice. However, many people continue to struggle because standard tests can miss other treatable gut issues, such as difficulties digesting fats or sugars. This clinical study compares standard GP care with care led by a specialist nurse. The nurse arranges extra checks, including breath tests, stool tests, and a gentle scan, to look for specific underlying conditions and offer targeted treatments. Participants are placed into one of the two care groups by random chance and followed for 12 months. Researchers want to see which approach provides better relief from diarrhoea and whether it provides good value for both patients and the NHS.
At a glance
What is this study about?
Irritable bowel syndrome (IBS) is a common condition affecting millions of people in the UK. Living with frequent diarrhoea, stomach cramps, and unpredictable bowels can make work, socialising, and daily life very difficult. It can also be costly, as people often spend money on prescriptions, over-the-counter medicines, and hygiene products.
At present, NHS doctors follow national guidance that uses basic blood tests to rule out serious illness before diagnosing IBS. Doctors then suggest diet changes or medicines. However, more than half of patients find their symptoms do not improve. Recent medical research suggests that many people diagnosed with diarrhoea-type IBS actually have other conditions that mimic IBS. These include bile acid diarrhoea (trouble digesting dietary fat), sugar intolerances, or bacterial imbalances in the gut, all of which have clear treatments.
The Lincolnshire POACHER study is testing whether a new care pathway works better than current practice. Half of the participants receive standard GP care, while the other half see a specially trained nurse who carries out targeted tests to pinpoint the exact cause of their loose stools. By tracking patients for one year, the researchers hope to show whether nurse-led investigation improves quality of life and saves money for the NHS.
Key takeaways
- The study compares usual GP care with a nurse-led service offering extra diagnostic tests for diarrhoea.
- It aims to find out if conditions often mistaken for IBS can be identified and treated more effectively.
- Participants are randomly assigned to either normal GP guidance or nurse-led testing.
- Progress, symptom relief, and everyday costs are monitored over 12 months.
- Participation is completely voluntary and will not change your right to standard NHS care.
Who may be eligible?
This study is open to adults who are visiting their GP with ongoing or frequent diarrhoea that appears to be IBS, and who have not had specialist hospital investigations for their gut symptoms before.
You cannot take part if you have certain warning symptoms that need immediate hospital investigation. These include unexplained weight loss, bleeding from your bottom, a lump in your tummy, persistent fever, or unexplained anaemia (low iron).
You will also be unable to join if you have had major bowel surgery, had your gallbladder removed, or have a known history of conditions such as coeliac disease, inflammatory bowel disease (Crohn's or ulcerative colitis), liver or pancreas disease, or bowel cancer.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I have frequent or continuous loose stools or diarrhoea.
- My GP believes my symptoms are likely to be IBS.
- I have not had specialist hospital tests or surgery for bowel problems in the past.
- I have not had my gallbladder removed.
- I do not have unexplained weight loss, bleeding from the bowel, or anaemia.
What does participation involve?
If you join the study, a computer will assign you at random to one of two groups. You have an equal chance of being in either group, and neither you nor your doctor can choose. One group receives standard IBS care from their regular GP. The other group sees a specialist nurse who arranges extra routine tests, which may include breath tests, stool samples, a look inside the lower bowel with a small camera (flexible sigmoidoscopy), or a capsule scan to check how you digest fats.
Both groups will be followed for 12 months. During this year, you will be asked to fill in questionnaires twice about your symptoms and quality of life. You will also keep a diary of any costs related to your gut issues, such as appointments, travel, and over-the-counter remedies.
Potential risks and benefits
Locations (1)
- Lincolnshire Community Health Services NHS TrustApproximateLincoln, England
Common questions
How is it decided which group I join?
A computer programme allocates you to a group at random, like flipping a coin. This ensures the study gives fair, unbiased results.
Are the extra tests experimental?
No. All tests used by the specialist nurse are standard, approved NHS tests that are already widely used for other gut conditions.
Is the capsule scan safe?
Yes. The capsule contains a tiny amount of radioactivity roughly equal to one to two months of natural background radiation from the environment. You can go about your normal day, but it cannot be used during pregnancy.
Will taking part cost me anything?
The study tests and specialist visits are free through the NHS. You will only need to spend personal time attending appointments and completing questionnaires.
Can I leave the study if I change my mind?
Yes. You are free to stop taking part at any point, and your normal GP and NHS treatment will continue as usual.
How to find out more
Jervoise Andreyev
Always speak to your GP or specialist before deciding to take part in a study.
Discussion
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