I have been pondering this post for many months; recent experience has persuaded me to highlight this much misunderstood issue, and the wider dilemma it raises for schools.
In the past decade, in a faculty of consistently around fifteen people, I know for sure that at least six other colleagues have had Irritable Bowel Syndrome (IBS). A couple of weeks ago, I encountered for the first time a pupil who had the courage to ‘fess up that she was having some difficulties in class because of the same problem. I wonder how many others there have been.
Depending on whom you believe, between ten and twenty per cent of the U.K. population suffers from this at some point in their lives; there is uncertainty because of much suspected non-reporting. Women are about twice as likely as men to have IBS but it can afflict anyone. Although it typically becomes active between the ages of twenty and forty, it can also affect children, particularly if there is a family history of it. While the condition can to some extent be controlled, there is no cure; in extreme cases, IBS can lead to severe debilitation.
Relatively little is known about its causes, though it most certainly is not ‘all in the mind’. In simple terms, the sensitivity of the digestive tract to pain is enhanced, while the process of peristalsis is disrupted. That said, mental states of health are known to aggravate it; stress is not a cause, but it is known to trigger the symptoms, which may explain why it seems prevalent amongst teachers.
Symptoms are very variable between individuals, but are certainly not the sniggering matter that the condition still seems to elicit. My main point here is that the impacts on an individual are far wider than is widely known. For example:
- Constipation or diarrhoea or sometimes both.
- Abdominal cramping and pain.
- Bloating and swelling of the abdomen.
- Excessive wind.
- Reflux and upper chest pain.
Equally significantly, but less widely known are the secondary symptoms, including:
- Lethargy similar to chronic fatigue syndrome.
- Lower back pain.
- Fibromyalgia overlaps significantly with IBS, and this causes whole-body muscle and joint pain.
- Urinary problems including night-time waking.
- Mental health effects. Because the bowel is a major source of serotonin, there is also a psychological element including anxiety and depression which most definitely is not ‘all in the mind’ and is not generated as a result of the general worry that the condition causes.
Some sufferers experience almost continual difficulties, while others have flare-ups with weeks or months of remission in between. Attacks can go on for weeks or months. The pattern of symptoms can change over time, and is almost unique to each individual.
I am not sure how widely this is known in schools, and how seriously it is taken by for example personnel and pastoral managers. Clearly, children who experience IBS need at least a degree of understanding. Perhaps more of an issue are staff who suffer from this or other ‘nebulous’ conditions that may affect their long-term performance.
When schools are run as exam factory-farms (to use a phrase I read this weekend) and when the prevailing mentality is that children’s education – or at least the results it yields – is a zero-sum game, then one might be concerned about the viability of teachers who have problems such as IBS.
While many continue to function with the syndrome, it can become a serious problem. For example, one of my former colleagues was hospitalised with suspected appendicitis that turned out to be severe undiagnosed IBS. In the longer term, IBS can be debilitating, sapping one’s energy and ability to focus, fragmenting one’s sleep and adding to anxiety. Given the open-ended nature of the condition, one might understand schools having concern about the impact of the syndrome on a teacher’s performance.
The all-or-nothing nature of modern education points in the direction that anyone who for any reason is perceived as a lame duck should be removed and replaced by a newer, fitter model. While there is of course legislation to protect people in times of ill-health, the nebulous nature of conditions such as IBS may mean that the protection is less effective, particularly is it is so person-specific and on-going.
On the other hand, nobody chooses to develop conditions such as this; the effects are bad enough without heavy-handed employers adding to the pressure. In the case of teachers, the very nature of their work may add to the problem. To be fair, I am not aware of harsh treatment of sufferers – but equally, experience suggests that the population at large is not aware of the far-reaching nature of the condition. School managers might need to consider the effects on susceptible individuals of events such as lesson observations, and the need to room such people near access to water and toilet facilities. This does not always happen.It may also mean that teachers need to use strategies that conserve their energy, or allow for recuperation.
In situations like this, where is the trade-off between the needs of the individual to make a living and the rights of the employer to have a fully-fit workforce?