IBS in med school

[confusedpremed12345]

Hi Everyone,

I'm an incoming M1 with IBS-D and was wondering if there are any others with this issue in med school. I've become progressively sicker over the past year, with significant weight loss (BMI of 16) and pain, chronic weakness, fatigue, and dizziness, as well as recurring fevers, in addition to my diarrhea and constipation. I often find it difficult to get through each day, and can no longer do certain things. For example, I can no longer drive due to my chronic dizziness. Given my weakness, I'm concerned about my ability to get through med school.

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[OneTwoThreeFour]

Hi Everyone,

I'm an incoming M1 with IBS-D and was wondering if there are any others with this issue in med school. I've become progressively sicker over the past year, with significant weight loss (BMI of 16) and pain, chronic weakness, fatigue, and dizziness, as well as recurring fevers, in addition to my diarrhea and constipation. I often find it difficult to get through each day, and can no longer do certain things. For example, I can no longer drive due to my chronic dizziness. Given my weakness, I'm concerned about my ability to get through med school.

I think you have reason to be concerned. This sounds like a disabling illness that is not controlled. I know plenty of people with IBS and even IBD who successfully went through medical school but all had their disease managed and none had daily symptoms like you are experiencing. You have to take care of yourself first. Best of luck.

 

[7331poas]

Hi Everyone,

I'm an incoming M1 with IBS-D and was wondering if there are any others with this issue in med school. I've become progressively sicker over the past year, with significant weight loss (BMI of 16) and pain, chronic weakness, fatigue, and dizziness, as well as recurring fevers, in addition to my diarrhea and constipation. I often find it difficult to get through each day, and can no longer do certain things. For example, I can no longer drive due to my chronic dizziness. Given my weakness, I'm concerned about my ability to get through med school.

You should discuss this with your physician if you aren't already. Hopefully you can bounce back. Good luck man

 

[confusedpremed12345]

I think you have reason to be concerned. This sounds like a disabling illness that is not controlled. I know plenty of people with IBS and even IBD who successfully went through medical school but all had their disease managed and none had daily symptoms like you are experiencing. You have to take care of yourself first. Best of luck.

well...that's...great.

 

[confusedpremed12345]

You should discuss this with your physician if you aren't already. Hopefully you can bounce back. Good luck man

Of course! My gastro wants to do more testing and gave me some drugs to try in the meantime.

 

[Dave1980]

You are going to find med school very, very difficult and residency impossible unless you get this under control OP. Best of luck.

 

[confusedpremed12345]

You are going to find med school very, very difficult and residency impossible unless you get this under control OP. Best of luck.

what do i do though? other than what my gastro tells me to.

 

[NITRAS]

I’d seriously consider a leave of absence. Or delaying your starting med school.

That’s much preferable that struggling and failing out or taking a LOA later. If you are going to be chronically sick.....going to med school may not be what’s good for you. It’s hard on people that don’t have medical or mental health problems.

 

[confusedpremed12345]

I’d seriously consider a leave of absence. Or delaying your starting med school.

That’s much preferable that struggling and failing out or taking a LOA later. If you are going to be chronically sick.....going to med school may not be what’s good for you. It’s hard on people that don’t have medical or mental health problems.

aren't there people with chronic illnesses who go to med school and do fine?

 

[OneTwoThreeFour]

well...that's...great.

I think you have to just have a conversation with the disability folks at your school. Standing for hours during a cadaver lab might not be something you're able to do, so make sure you get special dispensation/recognition that you may need breaks. As far as later on in your training...if you haven't found a regimen that works for you, third year is going to be very difficult. You'd likely be able to sit during rounds but during surgery you'll be reviewed negatively even with special dispensation from the admin.

 

[NITRAS]

I ain’t your doctor, but you’ve said several concerning things.

 

[confusedpremed12345]

I think you have to just have a conversation with the disability folks at your school. Standing for hours during a cadaver lab might not be something you're able to do, so make sure you get special dispensation/recognition that you may need breaks. As far as later on in your training...if you haven't found a regimen that works for you, third year is going to be very difficult. You'd likely be able to sit during rounds but during surgery you'll be reviewed negatively even with special dispensation from the admin.

Would receiving accommodations in med school negatively impact my ability to get into residency or get a job? I know that for licensing they ask about physical and mental conditions that impact your ability to do your job. I guess if I absolutely need it, then I have no choice, but if not, I'd be willing to be extra miserable to not have that on my record.

 

[confusedpremed12345]

I ain’t your doctor, but you’ve said several concerning things.

Well, I mean, I'm sick...
I'm considering a leave of absence, but if I do go, do you have advice for that scenario?

 

[Dave1980]

The first 2 years of med school will be doable as it is mostly self study.

The second 2 years will also be doable as you are still regarded as a student and no one really expects much out of you. If you need special accommodations during this time your grades (which are highly subjective) will suffer as will your recommendations but you will likely still be able to pass. Your ability to get a residency will be very limited as programs need people who can come in early, stay late, work hard, and generally make the service run smoothly.

If I were you I would start and keep going to the gastro and hopefully get things figured out relatively soon. I'm sure others would disagree. Do you have a diagnosis of IBS of IBD?

 

[Goro]

Hi Everyone,

I'm an incoming M1 with IBS-D and was wondering if there are any others with this issue in med school. I've become progressively sicker over the past year, with significant weight loss (BMI of 16) and pain, chronic weakness, fatigue, and dizziness, as well as recurring fevers, in addition to my diarrhea and constipation. I often find it difficult to get through each day, and can no longer do certain things. For example, I can no longer drive due to my chronic dizziness. Given my weakness, I'm concerned about my ability to get through med school.

Very sorry to hear this. Suggest asking for a deferral, and then seeking better, more intensive medical care for your IBS.

 

[Goro]

aren't there people with chronic illnesses who go to med school and do fine?

We can't tell you what you want to hear, alas.

 

[wonko]

aren't there people with chronic illnesses who go to med school and do fine?

Yes. There are those people. But each chronic illness is unique and yours is currently not working out. You need to sort that out ASAP. You struggle, might be on a dead end (hopefully not) and all the while presumably accumulating debt. I know people with chronic illnesses succeeding but that depends on excellent management, high frustration tolerance and an incredible amount of additional work. It may also not be applicable to your situation. Discussing LOA/medical leave with your academic guidance/local counseling should be what you are doing right now.

 

[Jaxey]

In my class only people that failed courses and/or had to repeat a year were those who had some underlying medical issues that were not controlled. Make sure your health is in check before starting. You do not want to put yourself at a disadvantage compared to your peers.

 

[AnatomyGrey12]

For example, I can no longer drive due to my chronic dizziness.

This is concerning. Go see your doctor and heavily consider a delay in matriculation. Your illness is impacting every day function to a significant point.

aren't there people with chronic illnesses who go to med school and do fine?

Yes, but they are almost always under control. We had a student try to bulldoze through with an out of control medical condition, they are now getting ready to remediate the year.

 

[Ligament]

This is sad. Difficult diagnosis to function with.

Would be very very difficult to get through med training if you cannot even drive.

Speak to your doctors, ask their advise. May need to write a letter to the med school asking for a deferrment.

 

[Giovanotto]

The first 2 years of med school will be doable as it is mostly self study.

The second 2 years will also be doable as you are still regarded as a student and no one really expects much out of you. If you need special accommodations during this time your grades (which are highly subjective) will suffer as will your recommendations but you will likely still be able to pass. Your ability to get a residency will be very limited as programs need people who can come in early, stay late, work hard, and generally make the service run smoothly.

If I were you I would start and keep going to the gastro and hopefully get things figured out relatively soon. I'm sure others would disagree. Do you have a diagnosis of IBS of IBD?

At most of my rotation sites, you miss more than a couple days and you're in deep trouble. Years 3&4 would be hell with what OP is describing.

 

[nimbus]

A better stronger human than I am. Maybe OP is too.

The Patient Who is Studying to be a Doctor - TMC News

What keeps me alive? High-calorie liquid nutrition—aka Nutren 2.0—running continuously through my feeding tube into my small intestine, and IV fluids running through my port into my heart. I’m not your typical medical student. Beneath my white coat lives a patient. In 2011, as an undergraduate...

www.tmc.edu

 

[DokterMom]

I’d seriously consider a leave of absence. Or delaying your starting med school.

That’s much preferable that struggling and failing out or taking a LOA later. If you are going to be chronically sick.....going to med school may not be what’s good for you. It’s hard on people that don’t have medical or mental health problems.

Once you matriculate, everything counts. A failure due to medical problems is still a failure, a red flag, and one that will be with you for the rest of your career. Deferring your acceptance due to a legitimate uncontrolled medical condition is NOT a red flag. Starting MS1 healthy will be SO much better for you, and you'll be much, much more likely to succeed.

I'm sorry for your troubles and wish I could tell you what you want to hear...

 

[confusedpremed12345]

A better stronger human than I am. Maybe OP is too.

The Patient Who is Studying to be a Doctor - TMC News

What keeps me alive? High-calorie liquid nutrition—aka Nutren 2.0—running continuously through my feeding tube into my small intestine, and IV fluids running through my port into my heart. I’m not your typical medical student. Beneath my white coat lives a patient. In 2011, as an undergraduate...

www.tmc.edu

woah that girl is a whole other level of resilient...

 

[deleted939001]

If you need special accommodations during this time your grades (which are highly subjective) will suffer as will your recommendations but you will likely still be able to pass. Your ability to get a residency will be very limited

this is neither true nor legal.

 

[studentdocftw]

BMI of 16 and dizziness while driving? You shouldn't start school. Try deferring for a year and use that time to get your IBS under control and your weight and stamina up. Next 7 years are going to be grueling...starting out unstable is a recipe for disaster. Good luck and stay healthy.

 

[Angus Avagadro]

My roommate in med school had Crohns and even developed fistulas during pre clinical. Working with his doctors, he did fine and graduated on time. You need to be in optimal condition before starting school. If not, you could start and withdraw if it is too much. A word of caution, to withdraw with full tuition refund is school dependent. At our school it is only after a few weeks. Best advice is to be under control and stable for a period of time before starting. Good luck and best wishes.

 

[Giovanotto]

I knew someone who had IBD (UC) that managed to get through years 1&2, albiet with some difficulties, but by year 3 things were so bad he ended up dropping out of medical school altogether.

I started medical school in tip-top shape, and by now (year 3) I'm completely knackered. I can't imagine starting out with your clinical picture.

 

[Podstar]

I have IBS-D and it usually acts up during exam cycles due to stress. I take Dicyclomine PRN, have started working out more, practicing stress management, and improved my diet immensely. I have had significant improvement with this combination and have gone from a BMI of 16.5 to 20.5. Not saying this will work for you, but it’s just my experience.

 

[ciestar]

You’re not in a good place health wise to start med school right now.

I just came off nights on my sub-i. These were 15 hour days, overnight, with no sleep for a week. You’d be expected to do this in residency too. Get your health under control. If you’re to the point you cannot even drive, your health is not worth further sacrificing for med school. Med school isn’t going anywhere, ask for a deferral.

 

[mrbreakfast]

As others have pointed out, met school is significantly harder, and less forgiving, than undergrad. Not being able to drive is a huge issue in itself just for starters. You need to get this under control.

The second 2 years will also be doable as you are still regarded as a student and no one really expects much out of you

Agreed with the other poster: at my program, missing more than a day or two on a clerkship - for any reason - puts a student in the clerkship director's office.

I just came off nights on my sub-i. These were 15 hour days, overnight, with no sleep for a week. You’d be expected to do this in residency too.

This is what the "tough" rotations in med school are like, but also what most of residency is like. In my specialty, and in many other specialties, a 70 hour week is considered "light." I'm sorry, but based on how your describe your symptoms, this ain't happening.

 

[OraclePL]

There's people in your situation who've made it through, but you need better control first. Defer matriculation and get 2nd/3rd opinions from big academic research centers. Make sure you seek out an IBS specialist. Getting good control of your symptoms could alter your entire career trajectory.

The reason people are expressing concern is the symptoms you're describing. Having "difficulty making it through the day" has to be sorted out prior to medical school, once you jump in you're in for some days with very long hours.

Can you make it through medical school with your condition? Absolutely. But you have to get optimal control and it that means deferring for a year and seeking out opinions from IBS-D specialists, then so be it.

 

[DokterMom]

woah that girl is a whole other level of resilient...

She is! And maybe you are too.

But the key difference is that taking a year now to get your symptoms under reasonable control -- to the point where you can drive safely again and 'get through the day' well consistently -- that's very possible for you, probable even. (In fact, postponing the 'meat grinder' will almost certainly help in that regard.)

OK, she didn't do this, and she's still succeeding. (Though if you read the whole article, it seems not all of her supervising attendings would fully agree that she is, in fact, succeeding.)

The thing is, your own personal odds of success go up or down dramatically based on this one [yes, heart-wrenching] decision. If you're still really sick next year but still really determined, accept that your situation may always be sub-optimal and march forward anyway. If you're healthier next year, start then, knowing that you made a conservative and wise decision to delay immediate gratification in favor of achieving lifelong goals. But if you start now and your health gets in the way, how will you feel knowing that you screwed up?

Put yourself in doctor shoes: What advice would you give to your patient?

 

[Planes2Doc]

You should speak to a physician. If all gastrointestinal etiology is ruled out, you should see if there is an underlying psychological cause. A lot of anxiety can be subconscious, and can rear its ugly head in medical school. Just remember that medical schools have counseling services readily available, and that there is no shame in seeking help from a psychiatrist or any other professional. Good luck!

 

[MSTP18]

OP, are you female? I've seen plenty of women in particular who get diagnosed with IBS who don't actually have IBS and instead have endometriosis all over their intestines or autonomic disorders or some other condition that isn't GI in origin so of course they have perfectly normal colonoscopies and just get labeled IBS without further workup (and in young people, plenty of cases of celiac and IBD that on first presentation with symptoms had normal scopes and biopsies and now years later the hallmark pathologic findings are present). Your condition sounds pretty severe and if you've just been carrying an IBS diagnosis for a few years without much re-evaluation it may be time to re-consider.

 

[confusedpremed12345]

OP, are you female? I've seen plenty of women in particular who get diagnosed with IBS who don't actually have IBS and instead have endometriosis all over their intestines or autonomic disorders or some other condition that isn't GI in origin so of course they have perfectly normal colonoscopies and just get labeled IBS without further workup (and in young people, plenty of cases of celiac and IBD that on first presentation with symptoms had normal scopes and biopsies and now years later the hallmark pathologic findings are present). Your condition sounds pretty severe and if you've just been carrying an IBS diagnosis for a few years without much re-evaluation it may be time to re-consider.

Yes, I am female. I only started having symptoms a year ago, and my health has deteriorated rapidly since then. My blood work came back normal, but I have a colonoscopy and CT scan scheduled to test for IBD. I'll ask my GI if they have thought about endometriosis as well. In the meantime, I've been started on xifaxan and dicyclomine.

 

[MSTP18]

Yes, I am female. I only started having symptoms a year ago, and my health has deteriorated rapidly since then. My blood work came back normal, but I have a colonoscopy and CT scan scheduled to test for IBD. I'll ask my GI if they have thought about endometriosis as well. In the meantime, I've been started on xifaxan and dicyclomine.

I obviously don't want to get into medical advice but quite frankly this doesn't sound like IBS. I'm sure there are people on here who have friends and family with "severe IBS" but I just point them back to my earlier post regarding the misdiagnosis of IBS. I think the people telling you to postpone matriculating are right. Quite frankly, I do not think you would do well in med school in your current state and despite the fact that it is illegal to hold a medical condition like this against you, the facts are that such judgment does happen both consciously and unconsciously, especially if the only diagnosis you carry is something like IBS. As someone else said, if this is truly your new baseline, so be it, you'll have to find a way to make it work, but I don't think this has to be your new baseline and spending a year now getting in under control will pay major dividends for you in terms of your physical health, mental health, and career health.

 

[confusedpremed12345]

I obviously don't want to get into medical advice but quite frankly this doesn't sound like IBS. I'm sure there are people on here who have friends and family with "severe IBS" but I just point them back to my earlier post regarding the misdiagnosis of IBS. I think the people telling you to postpone matriculating are right. Quite frankly, I do not think you would do well in med school in your current state and despite the fact that it is illegal to hold a medical condition like this against you, the facts are that such judgment does happen both consciously and unconsciously, especially if the only diagnosis you carry is something like IBS. As someone else said, if this is truly your new baseline, so be it, you'll have to find a way to make it work, but I don't think this has to be your new baseline and spending a year now getting in under control will pay major dividends for you in terms of your physical health, mental health, and career health.

What should I be asking my gastroenterologist?

 

[kaoticvanity]

When it comes to a situation like this, do you all recommend seeking accommodations for anxiety related to IBS flares or the IBS itself? Which would be less likely to demonstrate an inability to meet the physical demands of the clinical environment?

 

[Just D.O. it]

it is illegal to hold a medical condition like this against you

A very common misunderstanding of the ADA. The ADA does not provide a blank check for anyone with a disability to do anything they want. It states that people with disabilities are entitled to “reasonable” accommodations. If their needs are not “reasonable” they can absolutely be penalized/dismissed. OP has stated they get so dizzy they cannot even manage a (presumably short) drive. If OP is not able to do that, it seems to me that even the basics expected of med students would not come easy to them. Could they sit through a cadaver lab? A long exam? Stay focused and oriented during rounds during clinical years? If OP can’t manage these, I don’t think they are in a condition to be able to succeed in or even get through medical school.

I strongly second the advice already given. I think you will flunk out in your current condition. Take a medical deferral and get a second and third opinion on your diagnosis/treatment.

 

[NotAProgDirector]

The OP from this thread was 2019, long ago. Looking at their post history, they are now an M3 so have made it work. Tagging them for some follow up: @confusedpremed12345

Regarding the new question -- it doesn't matter. You can request accommodation for your clinical picture, and it doesn't matter if it's for the IBS or anxiety. What matters is what the accommodation is. If it's something that's reasonable, it won't be a problem. "Reasonable" is somewhat in the eye of the beholder. If you do get accommodations, that is not reported anywhere.