PCOS is a strange one for you to throw in there considering it has a physical manifestation that can be very reliably tested for via an ultrasound. The others are things that are quite often diagnosed via process of elimination and don’t have definitive tests.

People get negative ultrasounds and claim doctors just hate them or refuse to help them.

I think a part of this is online communities spring up around these diseases and a doctor telling you that you don't have it is basically them telling you they don't get to hang out with your friends anymore.

Better data exists for IBS on this line of thinking:

> The Illness Attitudes Scales (IAS) and the Beck Depression Inventory (BDI) were administered to 40 patients with irritable bowel syndrome (IBS) and these were compared with 35 patients with organic gastrointestinal (GI) disease, 37 depressed patients, and 40 healthy volunteers.

> All the patient groups had abnormal IAS scores compared with the healthy group, but these were most marked among the IBS patients with elevated scores on six out of the eight subscales. Three of these were specific to the IBS patients: bodily preoccupation, hypochondriacal beliefs and disease phobia.

https://pubmed.ncbi.nlm.nih.gov/7595881/

I don’t have a source handy, but I seem to recall that ultrasound as criteria for PCOS has been criticized recently because it has a high rate of both false positives and false negatives.

What do you suggest is done then? Given some people experience legitimate IBS, what quantity of false negatives (i.e. legitimate sufferers who are ignored by the medical system) are you willing to tolerate?

Also - given medical developments in gut health on GABA, the gut-brain link is not so crazy. So your study could be a reverse causation.

> What do you suggest is done then?

After no physical ailments are detected, they should be treated by psychologists rather than physicians.

So your priors are the we've got an omnipotent medical system? I really wish we did!

Is a brain gut link or not? If the gut isn't the problem the next stop would be the brain.

And if the brain seems fine, where do we go then?

If medical science can't find anything wrong, what exactly would they be treating?

This doesn't say what you think it does. IBS being co-morbid with anxiety is not evidence that people are spuriously identifying as sufferers. It's the expected finding for a disorder in which psychological stress and the brain-gut axis are thought to be major causative factors.

Maybe part of the problem is that IBS(-like) symptoms, and many "fuzzy" / hard-to-diagnose ones (fatigue, etc) are also caused or exacerbated by anxiety and frustration and emotional distress.

So if I'm not hyperchondriac, but am frustrated and stressed by (x) random symptom or covid related (y), or being off sick w/ "normal" Covid & struggling to regain energy, then if I'm emotionally distressed by it, then may develop IBS and fatigue symptoms on top of that - which then feeds into the loop...

(Said as someone for the last several months currently struggling with a whole bunch of symptoms and not managing to get any helpful diagnosis or area I can work on to improve things...)

> also many more people claim to have without evidence

I've long been curious what the ratio is in various situations like this. It seems the lynchpin for any argument for withholding support. I've only ever seen the equivalent of "well obviously" on both sides and never any data

When my wife first had ongoing symptoms after covid (before it had a snappy name), it was interesting how many people wanted to think that somehow she was making it up - and that being trapped in bed/on the sofa while I was out having fun with the kids was some sort of 'affectation'.

As people understood what long covid was and does, people generally came around to the idea, but still (mainly online) people have this opinion that 'people must be making it up' - despite SARs being known to cause similar long term issues for some of those infected, and some people having long term impacts from Spanish Flu 100 years ago.

IBS is a syndrome (a grouping of symptoms), not a disease. It, by definition, has no clear cause or treatment. Also - it is pretty easy to prove you are experiencing these symptoms.

The body is a pretty complex thing, it can be difficult to determine the underlying cause of a symptom even if we do have an underlying understanding of what the body is doing (and sometimes we don't!).

Lol... Very tactfully worded post there .. Kudos to you for that.. I certainly could not be that tactful

"...another disease people actually get but also many more people claim to have without evidence."

Lyme disease can actually be detected. For IBS and long covid, you are making the "no true Scotsman" argument. Diagnosing those is basically filling a questionnaire asking in so many ways "do you feel like you have it?" The same is true for many mental illnesses, by the way. Not to discount people's experience of having these problems - they definitely are real - but since the "official" diagnose is very close to just people telling the doctor that they feel like they have it, self diagnosing is not as bad as you make it sound.

> hypochondriacs claim to have without evidence.

> people claim to have without evidence.

Bit of a technical note. Patients claim is the evidence on its own. Patient may be undiagnosed, but there is an evidence for such claim.

IBS, lyme disease, all sorts of allergies are very hard (and expensive) to diagnose. Some people have no money for doctors, and may not be even registered with GP.

If customer at restaurant says they have a peanut allergy, you better to believe them. Saying "there is no evidence for such claim" may get you in troubles very fast...

I don't understand the mindset behind a comment like this. Where does the confidence behind this opinion come from, when the knowledge basis falls below "bothered to Google it"?

The idea of a hypochondriac making a spurious claim to IBS is pretty ludicrous. You know if you have the symptoms or not, and IBS is probably the best possible outcome for someone with chronic bowel symptoms.

Lumping PCOS in with gluten allergy is giving "shit men believe about women's health." Maybe try listening to some women before forming opinions on their reproductive health.

Or perhaps there are significant links demonstrated in murine models of the multi-directional relationship of the gut-brain-immune axis, and that traditional models of disease are not sufficient to elucidate this?