Organic disease masquerading as IBS: an RCT in primary care

PROJECT TITLEThe Lincolnshire Poacher Study (Promoting Optimal Assessment to Change Health and Engineer an Economic Revolution)
Funding bodyNIHR Research for Patient Benefit Programme
Total funding £429,956
  • Professor Jervoise Andreyev, United Lincolnshire Hospitals NHS Trust
  • Dr Judith Cohen, Hull Clinical Trials Unit
  • Dr Murray Smith, CaHRU, University of Lincoln
  • Dr Sarah Redsell, University of Nottingham
  • Dr Sunil Hindocha, Lincolnshire Integrated Care Board
  • Mrs Alexandra Carlin, University of Nottingham
  • Mrs Debbie Jeffrey, Lincolnshire Community Health Services NHS Trust
  • Professor A. Niroshan Siriwardena, , CaHRU, University of Lincoln
  • Professor Graham Law, , CaHRU, University of Lincoln
  • United Lincolnshire Hospitals NHS Trust
  • CaHRU, University of Lincoln
  • University of Nottingham
  • Hull Clinical Trials Unit
  • Lincolnshire Integrated Care Board
  • Lincolnshire Community Health Services NHS Trust
Overarching aimTo investigate the effectiveness and cost-effectiveness of nurse-delivered structured care (assessment, investigation using simple test and management of gastrointestinal [GI] symptoms) in patients with suspected IBS in primary care compared with usual GP care.
  1. To investigate the effect of nurse delivered structured care for IBS patients on symptoms and quality of life.
  2. To measure the cost-effectiveness of this approach from a health service perspective.
  3. To undertake a process evaluation to explore the feasibility of training nurses to deliver structured care for patients presenting with IBS symptoms, and to understand the fidelity of delivery, contextual factors and barriers and facilitators to wider adoption.
MethodsRandomised controlled trial
OutcomesPrimary outcome: IBS severity scoring system (IBSSSS) score at one year.


Secondary outcomes include:

  • Economic evaluation of the healthcare and patient costs.
  • Change in quality of life at 1 year.
  • Time to symptom improvement.
  • Conditions diagnosed at any time from randomisation to end of 1 year follow up.

Peer reviewed publications and conference presentations


ImpactThis is the first large-scale, specifically designed to assess missed organic disease as a cause of IBS-like symptoms, which if positive will bring health benefits to a population where there is substantial unmet need while reducing long-term costs..

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