Dr Bill Pring - AMA Chairperson of Public Health Committee, with Mike Jeffreys, Radio 2CC

Doctors and psychiatrists believe the stress and frustration caused by excessive gambling could also trigger a painful and debilitating condition known as irritable bowel syndrome. But the Australian Hotels Association says of the AMA at this stage, it seems they've been guilty of chasing a cheap headline at the expense of their place as the responsible representatives of the medical profession. To respond to this, on behalf of the AMA, I have the Public Health Committee chairman, Dr Bill Pring, on the line. Doctor, good afternoon. Thanks for your time.

PRING: Hi, Mike.

JEFFREYS: Well, the AHA say the medical profession has a trusted place in Australian society and they haven't been able to quote 'produce a skerrick of evidence' to back up these claims about the migraines, nausea, anxiety, depression, irritable bowel syndrome. What's your position?

PRING: Well, we welcome the opportunity to get to the listeners out there the message that gambling does in fact produce a lot of bad health outcomes, if they didn't know already. Look, basically we did provide their Association with information. We said that we were producing a more meaty document in the new year, and we've decided after this to come out with the draft document as it is at the moment. It will be further accentuated with more work in the next few weeks. But it's certainly a meaty document that goes into the evidence that's out there, with scientific literature about depression and anxiety being associated with gambling, as a lot of people would understand, increased suicide rates. There's certainly an association with alcohol and tobacco over-use. And so, you know, and it also shows that gambling affects people that are already disadvantaged most severely which is, you know, these are all the sorts of things that are quite clear in the evidence.

I might just say that the issue of irritable bowel: I have been - I've tried to be very careful to explain all along, and we've never said that gambling causes irritable bowel syndrome. What we've said is that we know that gambling can be associated with anxiety and depressions. People are probably aware that, if you have anxiety symptoms in particular, you often have a lot of physical symptoms. You have, you know, palpitations, upset bowel in some people who have more reactive bowels than others. And, of course, if you have the underlying predisposition to irritable bowel syndrome, you get anxiety. If it's related to gambling, of course you can get an exacerbation of irritable bowel syndrome. But we're not saying that that's the cause of irritable bowel syndrome. It's just that it can be associated with a worsening of that syndrome if you happen to be vulnerable to it.

JEFFREYS: So all of these things, and does this include the migraines and the nausea, are related back to the anxiety and depression?

PRING: Exactly. Perhaps people don't realise that depression and severe anxiety are very physical conditions. I mean we are whole people. We react with our bodies and our minds. So that, if we take just the anxiety if you're very anxious, then you actually are reacting very strongly physically. And a lot of physical conditions can be brought on - usually you have the vulnerability beforehand but a lot of physical conditions can be made worse or brought on by increased anxiety levels. And it may well be that it's through the physiological effects, the effects on the body of being anxious, especially if you're anxious persistently, so things like migraines. So most migraine suffers know that they can easily get migraines when they get more tense or anxious. And people with irritable bowel symptoms or who have suffered them in the past know, as they get more anxious, they can easily have much worse symptoms. And a lot of other conditions are similar.

JEFFREYS: Now Richard Mulcahy, who is executive director of the AHA, has called on your organisation to quote 'join the hotel and gaming industries in constructive dialogue and research rather than engaging in sniping and criticism from the sidelines.' So what's your response?

PRING: Well, we haven't been on the sidelines. We've been fully in the frontlines telling people about the downside. I suppose, the costs to them, as individuals, and to society as a whole of gambling being too readily available and perhaps, you know, causing a lot of social… I mean it's besides the health costs. There are the social disruptions, the marriages and relationships that break-up because of pathological gambling and so forth. Some of these effects are very costly on the community. We've been right in the front-lines. We're, of course, happy to join with other groups that want to genuinely improve a situation, make sure people don't get into pathological gambling. But we think them attacking us is not really reaching out the hand of friendship to work with us.

JEFFREYS: Indeed. Doctor, I appreciate your comments this afternoon. Thanks for your time.

Ends