Unexplained abdominal troubles
Brad, 24 yrs old is suffering a long time from abdominal troubles. Often there is cramping pain, feeling of being bloated, sometimes diarrhoea. He has seen several doctors about this issue, has undergone lab tests, X-rays and endoscopic examination of the stomach and the colon. The results were favourable, nothing substantially wrong has been found. Different attempts of treatment did not help at all or just for short time. In the end he has been recommended psychosomatic treatment.
When Brad came for his first appointment with me, he seemed a bit embarrassed about what would be expecting him. However, after the first few minutes he got rather relaxed and we dived together into his story. It was surprising to him, that we did not concentrate on his digestive problems, but I wanted to know much more about his life, i.e. his working situation, his relationships with family members, his current partnership, the history of any of his illnesses from childhood on and much more. Through this complex approach we worked out a much wider picture of his health state than has ever been done before. We discovered some substantial issues, some unknown even to him, that could produce significant psychosocial stress.
In Brads case it was a long history of ongoing tensions with his employer and boss. Since he was working in a small company, relationships were even more important than usual. Now, Brad´s situation was complicated by the fact, that the company has reduced working labour by 2 people and he was the only one to continue. The work load was increased to almost the double and made Brad working long after hours. First he felt just tired and sometimes dizzy, later he started to have sleeping difficulties. Since the employer repeatedly promised to improve his situation soon, he kept to the job. Step by step symptoms of his body occurred, nausea, loss of appetite and more and more frequently diarrhoea. His state was so severe, that he started to seek medical help. He was examined as described above and learned, that there was nothing substantially wrong with his body, neither there was proof of any intestinal infection.
Once we turned his focus on his working situation and started to talk about it, things slowly got better. The connection made between his somatic symptoms and his working environment was new and gave him a possibility to do something himself about his intestinal problems. We checked the problem from all sides and in the end, Brad came to the decision he had to change something crucial in this respect. He spoke to his employer about it and finding out he was not willing to change anything for him, soon left the company. His symptoms still persisted for well 3 months, but then got milder until they disappeared completely.
Author: MUDr. Ondřej Masner – Head Physician at Psychosomatic medicine UNIC