Former GP: “I Gave Over 1,000 Patients an IBS Leaflet. I Should Have Been Looking for Worms.”

If your GP has ever told you it's stress, your hormones, your age or IBS, I'm sorry. For 22 years, I was that GP.

You sat across from me, and you said things like:

“I wake up flat and look pregnant by the time I go to bed.”

“As soon as I get home I'm straight in my pyjamas.”

“My wardrobe is full of skirts I can no longer wear.”

“I look pregnant and I'm a bloke.”

“A client asked me if congratulations were in order.”

“My husband says it's not as bad as I think.”

“I'm not making this up.”

You'd cut out bread, then dairy, then half the list on the low FODMAP sheet. “There's not much left to cut out,” one of you told me. You had a cupboard full of things that hadn't worked: peppermint oil, probiotics, Actimel, the apple cider vinegar you forced down every morning.

I had ten minutes with each of you. So I did what ten minutes allows. Bloods. A stool sample. Sometimes a referral for a colonoscopy.

They came back normal. And I said it: “It's IBS. I'm afraid you'll have to learn to live with it.” I handed you a printout and a prescription for mebeverine, and I called the next patient in.

When that didn't work, I offered some of you antidepressants for the pain. One of you looked straight at me and said, “I don't want the relief. I want some answers.”

I fobbed you off. Some of you left my room believing it was in your head. Or stress. Or your age. Or your fault.

It wasn't. If you're reading this and nodding, you're not a hypochondriac, and you never were. You knew something was wrong long before anyone listened.

Some colleagues won't thank me for writing this. I can live with that. I've seen what a drawer full of normal results cost my patients.

Here's how I found out I was wrong.

The Patient Who Changed My Mind

She was 52, a Year 6 teacher. Bloated every evening for three years. Three stool samples, all clear. A colonoscopy, all clear. I'd told her twice that it was IBS.

The third time, she didn't sit down. She put her phone on my desk and said, “Please don't give me the leaflet. Just look.”

Ten days into a cleanse her sister had posted her, she'd looked before she flushed. She'd taken a photo.

I'd been a doctor for fifteen years. I looked at that screen for a long time. Then I got up and closed the door.

What was on her phone explains your 9 pm stomach. It explains the 3 am wake-ups. And it explains why every test you've had came back clear.

And her sister's cleanse? It wasn't one herb from a health food shop. It was several herbs taken together, wormwood, clove, pumpkin seed and more, in one oil softgel. Remember that detail. It turned out to be the whole story.

It Isn't Random. It's a Feeding Schedule.

That evening I started reading what I should have read years before. None of it was in my training. Intestinal worms burrow into the gut wall and hide under a thick grey film, like wax. Embalmers have described that film for decades. GPs are never taught to look for it.

And the pattern you've been living with is the giveaway.

They feed when you feed. Every meal you eat, they get to it first. It ferments, and you swell. Then, in the small hours, they finish what's left. That's when they're most active, which is why your stomach rumbles and wakes you at three, and why you're flat again by 7 am.

Flat at 7 am. Six months pregnant by 9 pm. Every day. Whatever you eat.

The rest of the pattern fits too. They take the iron and B12 from your food before you do, so you're wiped out by mid-afternoon. They clog the gut, so you're never regular. Their waste leaks into you: that's the brain fog and the breakouts. And they lay eggs, so the itch comes back at night and it all starts again.

“Worms? Me? I'm Clean.”

I know what you're thinking, because my patients said it to my face: “Worms? Me? I'm clean. I'd know.”

So did I. It has nothing to do with being dirty. The eggs are smaller than a grain of salt. They're on the salad you washed, the dog asleep on your bed, your grandchildren's hands, the prawns on holiday. Careful, clean people carry them for years and never see a thing.

You didn't do anything wrong. You ate. That's all it takes.

Why Your Tests Came Back Normal

A stool test sees one sample, from one morning. They lay eggs in waves, so most days the pot looks clean.

It looks at what's loose, not what's attached. What's burrowed into the gut wall, under the film, doesn't show up.

A colonoscopy isn't a parasite test. It looks for inflammation, polyps and cancer. That's what “all clear” means.

The symptoms look like everything else. Bloating, tiredness, brain fog. So it gets filed under IBS, stress, the menopause or age.

A normal result doesn't mean nothing is there. It means nothing was in that pot, that morning.

IBS is what we write when we haven't found the cause. “A dustbin diagnosis,” one of my patients called it. She was right. You knew something was wrong. The test just wasn't built to find it.

Why Nothing You've Tried Has Worked

Peppermint oil and mebeverine ease the cramps and the trapped wind. They do nothing about what's making it.

Probiotics, Actimel and kefir add good bacteria to a gut where something else still eats first.

Low FODMAP and cutting out foods take food away from you. They still get to whatever you do eat.

Single-herb cleanses from a health food shop. One plant, a small dose, often dried out on a shelf. It can't get through the film. And most are two-week courses, while the eggs hatch around day nine. Stop on day fourteen and the ones you missed start it all again.

None of that was your fault. You didn't fail those treatments. They were aimed at the wrong thing, and you kept looking anyway. That's why you're still reading.

What Actually Reaches Them

The herbs that work on this aren't new. What's new is the research behind them.

Wormwood comes from the plant family behind the 2015 Nobel Prize in Medicine. In a controlled trial published in Veterinary Parasitology, wormwood extract cut parasite egg counts by 90% in 15 days in infected sheep, as effectively as albendazole, a prescription worming treatment.¹ In mice, it matched praziquantel against the dwarf tapeworm, a worm that infects people too.²

Clove. Its active compound, eugenol, stopped parasite eggs from hatching.³

Pumpkin seed knocked worms back at more than one stage, in the lab and in infected mice.⁴ It makes them let go of the wall.

Black walnut hull, oregano and garlic have been used for generations to make the gut a place they can't survive.

The herbs were never the problem. The way they're usually taken is: one at a time, at a dose too small to matter, for too few days.

What I Tell Patients to Look For

You're the kind of person who reads the back of the label. Good. When patients like you ask me which cleanse to buy, I give them five rules.

1. All of them together, not one. Wormwood gets through the film, pumpkin seed makes them let go, clove kills the eggs. Take one herb on its own and they survive it.
2. A dose printed on the front, because when a brand won't print the milligrams, there's usually a reason.
3. In an oil. The bitter compounds that do the work absorb in oil. A dry powder mostly passes straight through you.
4. Thirty days, not fourteen. You have to go past the day the last eggs hatch.
5. A guarantee you can actually use, and no subscription. Read the refund policy before you buy. Some say “all sales are final” in the small print.

Most of what's on the shelf fails at least two of those.

These days I ask every patient what they took. One name keeps coming back, from the ones who are flat by dinner: PURAVA.

I've read the label, the studies behind each herb and the small print. Here's how it does against my five rules:

• All of them together? Yes. Wormwood, black walnut hull, clove, pumpkin seed, garlic and oregano, in one softgel.
• A dose on the front? Yes. The equivalent of 6,600 mg a serving, printed on the front of the pouch.
• In an oil? Yes, a softgel. And no bitter taste, which matters when you're taking it for a month.
• Thirty days? Yes. Three softgels before breakfast, for thirty mornings.
• A guarantee you can use? Yes. I read the policy myself: sixty days, every penny back, and you keep the pouch. No subscription to cancel.

Check availability on the PURAVA website ›

The Questions My Patients Ask

“Is it safe?”

For most adults, yes. It's a food supplement, not a medicine. But I'll tell you what I'd tell you in clinic: don't take it if you're pregnant or breastfeeding, under 18, have epilepsy, liver or bile duct disease or a ragweed allergy, or if you take blood thinners. It contains walnut.

“I'm on omeprazole, HRT or thyroid tablets.”

Keep taking everything you've been prescribed. Show your pharmacist the pouch; every ingredient is on the back.

“Will I feel worse before I feel better?”

Some people feel a bit rough around days 4 to 7 and go to the loo more often. That's them dying off. Drink more water and keep going.

“Aren't the “worms” people see just gut lining?”

That's what a harsh, high-dose cleanse strips off. This is three small softgels in an oil, gentle on the gut. And gut lining doesn't take your bloating away with it. Ask the people who saw them what their evenings looked like two weeks later.

“What if I don't see anything come out?”

It's still working. Eggs and larvae are too small to see. You'll know by your evenings: the button still done up after dinner, no 3 am wake-up, still awake at the end of the film. Many people do see them between days 9 and 14. Look before you flush.

“Why not just buy wormwood on Amazon?”

Because it's one herb, in a dry powder, at a dose nobody can vouch for. It fails three of the five rules.

“Should my partner take it too?”

If you share a bed, a kitchen or a dog, yes. They pass between people who live together, so clear it at the same time.

“I've wasted so much money already.”

Then don't risk any more. Take the full thirty mornings. If you don't feel a meaningful difference, you get every penny back, and you keep the pouch. Nothing to post back.

What Patients Tell Me After Thirty Mornings

Days 1 to 3: more trips to the loo. Something is finally moving.

Days 4 to 7: a bit rough for some. That's them dying.

Days 9 to 14: many see them leave.

Week 3: flat by dinner. The button stays done up. No more 3 am.

Week 4: “You look ten years younger.” I hear that one a lot.

I'm not the only one seeing it. More than 56,000 people have taken PURAVA, and it holds 4.8 out of 5 from 16,343 reviews. But the words I remember are the ones from people who'd been told it was nothing:

“My GP said IBS for years. Day 12 I saw what it really was. Flat in the evening for the first time since 2019.”

Susan, Norwich

“Every test came back normal. Day eleven I saw them in the toilet and sat on the bathroom floor and cried, because I was not making it up.”

Diane, Leeds

“By 8 pm my shirt buttons were pulling. Day 10 I saw them in the toilet. Back at five-a-side for the full hour.”

Jamie, Bristol

“A woman at church asked when I was due. I said July, it was easier. Thirty mornings later I wore the green dress to her daughter's wedding.”

Bev, Croydon

The Teacher, Four Weeks Later

She came back on a Thursday at ten past five, after a full day of Year 6. She wasn't booked in. She'd come to show me.

A fitted navy dress with a belt, done up on the last hole. Flat, at five o'clock in the afternoon. “I slept eleven till six,” she said. “Every night this week. My husband keeps asking what I've had done.”

At the door she turned round. “I wasn’t making it up, was I?”

No. She wasn't. And neither are you.

So picture your own evening, four weeks from now. A proper dinner out with friends, pudding too, and you don't think twice about it. You get home and the button is still done up. You don't reach for the pyjamas. You stand side-on to the mirror before bed, and you don't look away. And on holiday this year, you wear the swimsuit.

If You Try It, Do It Properly

1. Three softgels before breakfast, with water. Every morning, for thirty mornings. Not fourteen.
2. Drink more water, especially on days 4 to 7.
3. Look before you flush between days 9 and 14.
4. If you share a bed, a kitchen or a dog, do it together.
5. Keep taking everything you've been prescribed.

Tonight

Tonight you'll have dinner, and you'll feel it start. The waistband digging in. The button. The pyjamas the moment you're through the door. Tomorrow at 7 am you'll be flat again, and you'll be tempted to think it's nothing.

It isn't nothing. A normal test was never the all-clear you were told it was. If it's been three years, that’s more than a thousand evenings in your pyjamas by eight. A thousand dinners they ate first, iron and all. Don't give them another thousand.

Tonight the button will go again. Tomorrow, before breakfast, can be morning one of thirty.

Where to Get It

PURAVA is sold through its own website. When I last checked, they were doing buy one, get one free: two pouches, so two full thirty-day protocols, for $69.99 instead of $139.99. Plenty of my patients give the second pouch to whoever they live with. Others carry straight on for sixty days, to catch any late hatchers. If you're both doing the full sixty days, they also do buy two, get two free: four pouches for $139.98.

Delivery in the UK is free, there's no subscription, and they put a short guide to the thirty days in the box, which is genuinely useful.

The guarantee is the part I always check, because so many of these brands hide “all sales are final” in the small print. Theirs is sixty days: if you don't feel a meaningful difference, every penny back, and you keep the pouch. Nothing to post back.

One warning. They make it in small batches, because the wormwood is only harvested once a year, and it does sell out. If it's gone when you click, they'll let you sign up for the restock.

Check availability on the PURAVA website ›

You weren't imagining it. You never were. You knew. Now stop feeding what’s feeding on you.

Dr. Richard M.

About the authorDr. Richard M.

Dr. Richard M. spent 22 years as a GP in England before moving into private practice focused on the gut. He writes about the symptoms general practice too often files under “IBS”.