Sam Launder, a 33-year-old commercial director living near Oxford, underwent major surgery to remove his bowel and rectum after years of worsening stomach pain were misdiagnosed as irritable bowel syndrome.
Launder was 27 when he first experienced severe gut symptoms, but doctors repeatedly attributed his condition to irritable bowel syndrome (IBS) before a colonoscopy revealed he was actually suffering from ulcerative colitis.
The health issues began when Launder's bowel movements increased to four or five times a day. "At first, this didn't worry me, I was fit, active and healthy, and was working in a busy role as a restaurant assistant manager," said Launder, who also went to the gym four times a week and competed in ballroom and Latin dance competitions.
As the frequency grew to six or seven times a day, Launder was forced to run to the bathroom to arrive in time. "Still, I put off going to the doctors for a while because I had a feeling it might be IBS and that there wasn't much that could be done," said Launder, who lives with partner Ellie, 25, and their two-year-old daughter Evie. After several months of symptoms, a doctor diagnosed him with IBS, recommending a food diary, avoiding fatty and spicy foods, and drinking plenty of fluids.
IBS is one of the most common gut conditions, affecting around 15 percent of adults in the United States according to the American Medical Association, as well as about one in five adults in the United Kingdom. Because no specific test exists for IBS, doctors diagnose it based on symptoms after using blood and stool tests to exclude conditions like celiac disease and inflammatory bowel disease (IBD).
Diagnosing gut conditions and identifying red flags
Professor Anthony Hobson, a gastrointestinal scientist and clinical director at The Functional Gut Clinic in London, explained that abdominal pain is the essential indicator for IBS. "You will not be diagnosed with IBS if you don't experience its key symptom, abdominal pain," Professor Hobson said. "But abdominal pain alone does not necessarily mean you have IBS."
Professor Hobson noted that bloating is the other most common symptom, along with diarrhea, constipation, or alternating bowel habits that are usually, but not always, relieved by bowel movements. Symptoms are typically exacerbated by hard-to-digest foods, including onions, garlic, dairy products, high-fiber foods, and high-sugar fruits like apples.
While diagnosing IBS based on symptoms is standard, Professor Hobson warned that doctors must look for "red flags" such as unintentional weight loss, blood in stool or rectal bleeding, a family history of colon cancer, or new symptoms in patients over 45. "If any of these are encountered, some simple stool tests should be given to check for inflammatory markers to exclude inflammatory bowel disease and cancer," he added.
As Launder's symptoms worsened, he began questioning his diagnosis. "If I went out, I had to work out where the nearest bathrooms were, avoided eating for long periods before travelling and would take a change of clothes just in case of an accident," he said. After reading online that his symptoms sounded more severe than IBS, he returned to his doctor but was again told he had IBS.
In early 2020, about a year after his second IBS diagnosis, Launder developed excruciating backache and began passing blood. His doctor referred him for a colonoscopy, where a tiny camera was inserted into his colon. The scan revealed ulcerative colitis. "I'd never heard of the condition and didn't really understand what could potentially come of it," Launder said.
Ulcerative colitis causes and medical distinctions
Ulcerative colitis causes the lining of the large bowel to become inflamed and sore, forming painful ulcers when the immune system mistakenly attacks healthy gut tissue. A recent study indicates that IBD cases, including ulcerative colitis and Crohn's disease, are rising in the U.S., particularly among young people, with experts estimating 100,000 people under 20 now have IBD. Researchers believe environmental factors like diet, low fiber intake, and antibiotic use may alter gut bacteria and immune function.
Dr Rishi Goel, a consultant gastroenterologist at the New Victoria Hospital in London, explained that both IBS and ulcerative colitis usually affect people in their youth. "Because some symptoms overlap, it's not uncommon for sufferers to confuse these conditions, and it can also be a challenge for doctors when choosing investigations and making a diagnosis," Dr Goel said, noting that colitis involves diarrhea, pain, and rectal bleeding, whereas IBS causes bloating, pain, and altered bowel habits without bleeding.
Dr Goel emphasized that a fecal calprotectin stool test can distinguish IBS from IBD by looking for a protein signaling bowel inflammation, which is absent in IBS. He warned against delaying diagnosis, as spreading inflammation responds less well to treatment. "In Sam's case, if he'd had early fecal calprotectin testing it may have raised suspicion of ulcerative colitis sooner and prompted further investigations," Dr Goel added.
Failed medical treatments and physical toll
For three years following his diagnosis, Launder tried various prescribed medications and hospital infusions without success. He relied on high doses of the steroid prednisolone as the only relief, though doctors were reluctant due to risks of weight gain and weakened bones. At his worst, Launder was running to the toilet up to 25 times a day.
"I was very open about my condition at work and my team were aware. I managed to hold down my job by planning ahead and knowing where the toilets were," Launder said. "But my social life was harder. I was constantly cancelling plans because I was embarrassed about suddenly having to rush to the toilet. It got to the point where it just felt easier not to go out." He dropped out of dancing and the gym, and steroid side effects caused his weight to rise from 165 lbs to 253 lbs, giving him a "moon face."
Surgical procedures and long-term recovery
By July 2022, severe inflammation left Launder's consultant with no choice but to advise removing his colon to prevent severe bleeding, bowel perforation, or dangerous colon swelling. "Ultimately there was no choice, I couldn't continue to live as I was," Launder said. He underwent an eight-hour surgery, taking longer than expected because his colon was in a far worse state than anticipated, and was given a permanent stoma to collect waste.
"When I came round, I didn't want to see it initially. But once I got used to fitting and changing the stoma bag, I felt massive relief," Launder said. "Now for the first time in years, I could leave the house without worrying about where the nearest bathroom was. I had freedom again." Launder added that he remains self-conscious about the stoma bag, wearing support belts to hide it.
In July last year, Launder underwent a second operation to remove his rectum due to long-term cancer risks. The procedure is known as "Barbie butt" surgery because everything is stitched closed to leave a smooth appearance. "The recovery was incredibly difficult. I could only lie on my side or walk, I couldn't sit, because the area was so painful after surgery," Launder said, adding that he suffered painful infections and bag leaks following a simultaneous hernia repair.
Recovery took between six and nine months. "My daughter had only recently turned one, and it was heartbreaking not being able to pick her up," Launder said. Now feeling much more positive, he has lost around 33 lbs and returned to the gym. "I want to keep getting stronger for myself and so I can be as active as possible with our daughter," Launder said. "It's been a difficult few years, but I've always tried to stay positive and be grateful for every day. I hope my story encourages people not to ignore symptoms if they know something isn't right and to keep pushing for answers."
