The endoscopy I had before starting

The overlap in symptoms is the genuine difficulty. Two things producing similar sensations and no obvious way to tell them apart from inside.

Gethin, I have been where you are and I would rather say so than stay quiet.

My team's approach was to change one thing at a time and wait, which was frustrating and correct.

Gethin — taking your question as you asked it, because I think the thread has widened it.

I asked for a slower schedule specifically because of my history and it was granted without argument. I had expected to have to make a case.

No advice, just company. Here if it helps.

What I did not expect was how much better I felt once somebody acknowledged that the combination was complicated. The acknowledgement itself helped.

I keep a note of what my normal actually is, written down when I am well, because from inside a bad fortnight I cannot remember.

What changed things for me was a dietitian who knew both sides. General nutrition advice had been useless and specific advice was transformative.

My records were a mess across three services and putting them in order myself, once, in an afternoon, made every subsequent appointment better.

The most useful question I asked was what would make them want to stop, so that I knew what I was watching for rather than watching for everything.