Q: Hi there, I am an avid diver and I have been diagnosed with ME. As little is known about ME I need to know whether I should continue diving. Most of my dives are 40m plus. The vast majority of time I don’t feel well enough, but on the rare occasions I do, is it advisable?

A: In 1955 the Royal Free hospital in northwest London had to shut for two months due to a mysterious illness which caused fever and persisting fatigue in 292 staff members.
Initially called ‘Royal Free disease’, investigations into the cause led to the coining of the term ‘myalgic encephalomyelitis’ (ME) for the condition. The fact that it now goes by a plethora of names including chronic fatigue syndrome (CFS), post-viral fatigue syndrome and ‘yuppie flu’ just goes to show how poorly understood a problem it is. Interestingly, many veterans with Gulf War syndrome have the same symptoms.

Diagnosis is difficult, relying as it does on subjective criteria, but generally it involves unexplained fatigue of six months or more, which is not due to exertion and which is unrelieved by rest. Numerous other symptoms may occur, such as memory problems, sore throats, joint and muscle pains, and unrefreshing sleep. If any other illness could cause the symptoms then ME is excluded. So there’s plenty of scope for controversy here, as you can see; initially the medical community was sceptical even of the existence of the disease. The stigmatising ‘attention-seeking’ label is still very much a problem in the public arena.

Not surprisingly, most sufferers do not feel well enough even to contemplate diving. This, in some ways, is the best guide, as it’s very difficult to give concrete advice on whether it’s safe to dive or not. All sorts of theories as to the cause of ME abound. The only fact is, no-one knows. As such, the best advice I can give you is if you feel up to diving, then make sure you get a full diving medical first. If you can put in a good showing on the ears, heart, lung and exercise tests, then I’d say you could dip your toe into the water.

Q: I’m a bit embarrassed to ask this but hope you can help. I’m a new diver, and I was diagnosed with irritable bowel syndrome (IBS) recently. I’ve done a few open water dives and I find that I get really gassy during them, and afterwards my stomach feels bloated and I have to pass a lot of wind. Is this normal? I’m guessing it might have something to do with the IBS but it’s a bit awkward having to run off to the loo as soon as I finish a dive! I am going on my first liveaboard soon so any advice would be very helpful.

A: Unfortunately, production of some intestinal gas is an unavoidable part of digestion. A human can generate anything up to two litres of wind a day, although your average is nearer 600ml. Its major component is nitrogen, but sadly farting a lot does not reduce your DCI risk! The problem is that all this gas has to obey Boyle’s Law when diving, so it will expand, contract and generally cause discomfort unless it is expelled, from either end of the gut.

Some IBS sufferers do generate a lot of wind, and diving will therefore exacerbate the discomfort, but as long as there is ‘light at the end of the tunnel’, as it were, then the gas will escape and relief will ensue. The best advice I can give is simply to avoid anything ‘flatogenic’ on a dive trip. The obvious culprits include beans, cabbages, onions, mushrooms, etc, but also fizzy drinks and milk. With any luck you can then spare your cabin buddy a fragant night on your first liveaboard…

Main image: Stock photo from Pixabay

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