Syndromes

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A medical syndrome – for example Irritable Bowel Syndrome – is a recognisable set of symptoms without an establish biological cause. In the case of  Irritable Bowel Syndrome , for instance, your bowels don’t work properly, maybe with diarrhoea or constipation or abdominal pain, or all of these, but there is nothing obviously wrong with them s that any conventional medical investigation can detect. There is no inflammation to speak of, or anything like that. But you still have the symptoms. Hence it is a syndrome. Another one of course is Chronic Fatigue Syndrome where you are really very low on energy, often crippling so, and yet there is nothing that can be found by conventional medicine – blood tests and so on – that can explain it.

Similarly some men suffer from Chronic Pelvic Pain Syndrome (CPPS), aka Chronic Prostatitis. The syndrome formerly known as Nonbacterial Prostatitis. As the NHS website says, with such a condtion the “cause of symptoms is not clear.” These symptoms may include:

- Pain in and around the genitals, lower back, anus, abdomen

- Urinary problems such as pain when passing water or the frequent urge to do so

- Sexual problems such as premature ejaculation.

All in all, not a very nice syndrome to have. Especially maybe when the cause is “not clear”.  Although would you rather have symptoms whose cause is not clear, or symptoms whose cause is clearly cancer, or something equally malign? I’d go for not clear myself, although I suppose the trouble with not clear is that it leaves you in a state of chronic uncertainty. “Maybe I have got some terrible disease that they just haven’t identified yet.” Worry, worry, worry! Another possibility is that, facing the doctor telling you that there is no obvious cause for your symptoms, you start to wonder if you are somehow making the whole thing up. Especially these days when people seem to doubt the existence of anything that cannot be measured by a blood test, an MRI or a fitbit.

As you can imagine, treating a syndrome with an unclear cause “can be challenging” – the NHS website again.

A while ago I read a book called “Teach Us to Sit Still – A Sceptics Search for Health and Healing” by Tim Parks. As I recall, the author was suffering from something like CPPS, a chronic pain condition with no obvious cause. His search for relief takes him, among other places, to an Ayurvedic doctor in India and a meditation retreat run by someone who used to be in the CIA. Its an amusing story, but instructive as well. And of course the title of the book (borrowed from TS Eliot) and the fact that meditation does, in the end, seem to provide some relief, suggest that seeing chronic pain as purely a physical problem is sometimes misguided – perhaps especially so when it is classified as a syndrome.
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A recent Chinese study of 440 men with moderate to severe CPPS suggests that acupuncture can durably improve the various symptoms of the problem. I guess one might speculate that the roots of traditional acupuncture being in a world-view that does not make the western Cartesian separation between mind and body may go part of the way in explaining why acupuncture might be a suitable treatment. An ancient Chinese medical proverb has it that “All pain comes from the Heart”, which sounds like it might be a bit of an exaggeration, but at least where syndromes are concerned, the Heart – not the heart as mere blood pump, but the Heart that can be broken, that can sink into ones boots, the Heart that holds those we love and which swells with joy, aches and sings – needs to be included in the treatment.