Fletcher mystery runs deeper than a virus



Darren Fletcher’s Manchester United career has been struck with significant ill fortune amid the trophies and personal glory since the Scotsman’s début a decade ago. Indeed, the Dalkeith-born midfielder’s first appearance for the club came almost two years after manager Sir Alex Ferguson had intended to deploy the then very callow youth. That the Premier League blocked 16-year-old Fletcher’s proposed introduction against Aston Villa in 2000 was perhaps a marker for a career to come. Since then Fletcher has suffered a serious leg injury during his youth, and then later ridicule from the terraces, a missed Champions League final and now a serious chronic illness.

On each occasion the midfielder’s determination, arguably far greater than his natural talent, has taken the 27-year-old to the very top of the game. Yet Tuesday, after officially announcing an extended absence from the game, Fletcher’s career is at more risk than ever. Suffering with an inflammatory bowel disease, ulcerative colitis, the Scot is to take an indefinite period on the sidelines; a huge blow both to player and club.

“Over the past year he has had several absence periods which we have attributed to a viral illness in order to respect his right to medical confidentiality,” read a United statement issued on Tuesday.

“Darren has, in fact, been suffering from ulcerative colitis (a chronic inflammatory bowel condition) for some time preceding this. Whilst he was able to maintain remission of symptoms for a considerable period this has proved more difficult recently and Darren’s continued desire to play and his loyalty to both his club and country has probably compromised the chances of optimising his own health and fitness. He has therefore accepted medical advice to take an extended break from the demands of training and playing in order to afford the best chance possible of achieving full remission once again.”

The Scottish captain first became ill last March, missing two months of the run-in with what was then described as a ‘mystery virus’. We now know it was nothing of the sort. But signs that Fletcher’s condition was serious were clear on the player’s return against Schalke 04 in the Champions League last May, with the Scot appearing gaunt having lost more than a stone in weight. Fletcher’s appearance had changed too, with the medication reportedly bloating the 58-cap international’s features. It is now clear the midfielder returned far too soon.

“The biggest thing was the weight loss,” admitted Fletcher in September.

“I lost close to a stone which for someone like me — I don’t have a stone to lose — was massive. That was the biggest thing, building my strength back up and putting my weight back on was a real struggle. I was stuck in bed for two weeks. But I had constant reassurance from the doctor that it was a bit of bad luck, a combination of different things that had a domino effect which set me back.

“I am a positive person so I expected to be back the next week, then it was a week later, and then I thought the next week. I just had to eat as much as I could to try to put it back on but even that is a struggle for me. I just ate as much as I could, protein shakes, meal replacements drinks.”

Fletcher’s absence, perhaps for the remainder of the current season, comes soon after captain Nemanja Vidić was ruled out for the campaign with injury. With Anderson out until the Spring and Tom Cleverley past New Year, Ferguson will now face up to life without a significant chunk of experience through his team’s spine. More to the point, the Scottish manager is facing a crisis over midfield numbers in the coming months. Even for a club of United’s size, the dual absences are a crushing blow.

Indeed, the question of whether United will now enter the transfer market in January – or at least entertain the thought – is a crucial one. After all, reports that the Glazer family has placed the club cheque book into lock-down are widespread and well sourced.

It is almost impossible, with the club’s senior central midfield options reduced to Michael Carrick and Darron Gibson, for Ferguson to now claim, as the Scot so often does these days, that he is happy with his resources. Throwing 37-year-old Ryan Giggs and Korean winger Park Ji-Sung into the mix hardly inspires confidence. Indeed, United’s options are so thin on the ground that Wayne Rooney and Phil Jones have been pushed into central midfield in recent weeks.

But United’s statement also raises plenty of questions. After all, the club has now admitted that not only did the medical team know of Fletcher’s condition well before Tuesday’s statement, it deliberately concealed it over the past nine months. The lack of veracity, even if Fletcher’s condition was obscured for reasons of privacy, will raise eyebrows. The cloak of secrecy only served to generate speculation.

Moreover, there is now an admission that deploying Fletcher has worsened the player’s condition. On the face of it, the club’s acknowledgement reflects poorly on the institution. After all, if United’s medical team knew of the player’s condition then it will also have advised – or been advised of – treatment options, presumably including the lengthy rest now prescribed. The question, coming so soon after Owen Hargreaves alleged mis-management of his own long-term problems, is a pertinent one.

Then there is the curious case of Fletcher’s contract, with the player signing a new four-year deal on much improved terms in May. It is perhaps the first known case of the normally parsimonious Glazer family extending a hand of financial generosity.

Further details will emerge in the fullness of time, but until then Ferguson is another man down, and a player’s career hangs in the balance.

United’s unanswered questions

  • Why did Fletcher play on with a condition that, in hindsight, was so serious?
  • Did Fletcher, as intimated in United’s statement, insist on playing in May and then August, or was any pressure brought to bear on the Scottish international?
  • If the player insisted on playing, why did United’s medical team not intervene? Was he cleared to play?
  • Why has United now broken typical club protocol, and Fletcher’s privacy, to announce the player’s true condition and absence?
  • Why is an extended break now the prescriptive cure if was it not in May? Or August?
  • Why was the player offered an extended contract when his long-term fitness was in doubt?

What is ulcerative colitis?

UC is an inflammatory bowel disease (IBD), which affects the large intestine. The sufferer usually displays constant diarrhea mixed with blood, although the condition is intermittent, with periods of exacerbated symptoms, and periods of remission. From the NHS:

The colon, also known as the large intestine, absorbs nutrients from undigested food and passes out waste products through the rectum and anus in stools (faeces). Ulcerative colitis causes the colon to become inflamed (swollen) and in severe cases, ulcers (painful sores) may form on the lining of the colon. These ulcers can bleed and produce mucus and pus. Symptoms of ulcerative colitis can range from mild to severe, with the condition being very unpredictable.

Symptoms can flare up and then disappear (go into remission) for months or even years. At its most severe, the entire colon can become inflamed (known as pancolitis). This form of ulcerative colitis is particularly challenging to treat. The causes for the condition are unknown, though research suggests that both environmental and genetic factors are involved.

Ulcerative colitis is an uncommon condition. It is estimated that there are ten new cases a year out of every 100,000 people. There are currently 100,000 people in England with ulcerative colitis. The condition normally appears between the ages of 15 and 30. The condition is more common in white people of European descent, especially those descended from Ashkenazi Jewish communities (Jews who lived in Eastern Europe and Russia) and black people. The condition is much rarer in people of Asian background. The reasons for this are unclear.

The outlook for most people with ulcerative colitis is usually quite good. Symptoms are often mild to moderate and can usually be controlled using medication. However, an estimated one in five people with ulcerative colitis have severe symptoms that often respond less well to medication. In these cases, it may be necessary to surgically remove the colon.

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  • leftback

    Your questions are pointless. UC is not like having a broken leg. The symptoms of UC are very unpredictable and they come and go depending on your condition and diet. It’s not something you can pick up with scans to determine the severity.

  • jazz

    I agree with leftback … your questions aren’t valid at all…. if this is unpredictable then how could uniteds medical team possibly know the correct course of action? I’m sure that this “extended rest ” is possibly the last thing left to try!

    • http://www.unitedrant.co.uk/forum/profile/admin Ed

      jazz – Sure, but questions are always valid. And I haven’t provided the answers… perhaps you know them? No? Exactly. Or is your point of the view the only one available? My questions are not just about Fletcher’s illness, but about the club’s conduct and economy with the truth. And by extension the decision to award Fletcher a new contract and not invest in a new midfielder.

  • Triggs

    I tend to agree with the above, you’re talking of an autoimmune disease like it’s a normal footballing injury that United failed to spot.

    Unless United have a gastroenterlogist/proctologist on the books, they are not likely to have any real say in his diagnosis or prognosis, they would have relied on external expert advice.

    This appears to be an unpredictable and fluctutating disease. As you’ve noted above it’s a rare condition and rarer still for a sufferer to be a professional footballer. The treatment is therefore not likely to be tried and tested. I don’t think it’s any surprise therefore that he’s suffered relapses.

  • uncleknobheadforfucksake

    eds clearly a fan of the word ‘dual’

  • timbo

    I suffer from the same disease, and though it can be painful at times, annoying to manage, and embarrassing in its timing and impositions, it has never affected my ability to lead a relatively normal and active life – if I was still active in sports, I can’t see how it would affect me other than the fact that I might suddenly get an urgent need to go to the bathroom – and then only while in the midst of one of the inflammatory periods.

    All I can think is that Fletcher must have an extremely severe case of the disease. I’ve never even remotely come close to being bed-ridden by Colitis, or suffered major weight loss – the worst of it is the sudden and almost uncontrolled urges to go, of keeping fresh underwear handy in the car etc in case of accidents, and of the mild and enduring pain one gets in the sides at times that’s akin to the lingering after affects of being hit in the groin (for a guy, at any rate!)

    If he’s having to take an absence of leave due to the disease then I think we’ve seen the last of Fletcher, because Colitis never goes away – once you have it, you’re stuck with it for life – which is why I find the comments about waiting for the disease to go into ‘remission’ somewhat baffling. It NEVER goes into remission, you simply get periods of relative stability through the year followed by period of inflammation – medication like ASACOL help to control and nullify the symptoms, but it never goes away. You can treat cancer by cutting away the malignant areas, by using Chemotherapy, and hope enough is done to push the deathly disease into a state of remission – to stop the spread of cancerous cells. You cannot drive Colitis into remission, because that would mean going to the root of the problem, the autoimmune system, and getting it to shut down it’s attack on the intestinal tracts. Unless I’m behind the times, the best you can do is manage the disease, not make it go away.

    If a highly paid sportsman with the ability to seek the best medical attention money can’t find a way to manage the disease in the short term for the sake of his sport, it stands to reason that things aren’t going to get any better in the long term – unless of course they come up with a cure.

    To clarify points made by some, no, it is not some kind of new or recently identified disease, nor are the pharmaceutical procedures for dealing with it new or untested – ASACOL has been around for a while, as have other medicines, while those in worst case scenarios may require steroid treatment to deal with the problem – steroids are hardly new. Under the circumstances I don’t think FIFA or CAS would have any problem granting Fletcher special dispensation to use them.

    Best of luck to Fletch – he’s given his all for the club and I wish him well.

  • denton davey

    I’ve had to deal with “irritable bowel syndrome” since I was a kid although it was only diagnosed when I was 17/18. It’s an awfully debilitating medical condition and there’s really no obvious solution or treatment – it just comes and goes as “flare-ups” happened for reasons that seemingly have their own dynamic (not due to diet or stress or anything else, in my case).

    In any event, if my experience is anything to go by then it would seem very, very unlikely that DarrenFletcherinho will ever regain his strength to be a top-level athlete playing a gruelling sport in the most physically-demanding position.

    The very fact that he has been able to soldier-on while still under the influence of the disease tells us a lot about Darren’s character and his competitive drive but, unfortunately, it’s equally true that his performances have declined from his peak in the 2008/9 season. He was a lynch-pin of the team. that got to the CL final in Rome, only to be banned for a terrible decision in the semi-final match.

    If I was a conspiracy theorist – or superstitious – then I’d think that UTD’s midfielders have been cursed. First, TheEnglishPatient spent three years on the sidelines with the worst case of tendonitis that Dr Steadman had ever seen; now, DarrenFletcherinho (football genius) has had his career blighted by a unlikely medical condition. All I can hope for is that this curse doesn’t work in threes – I have great hopes for Phil Jones !

    • Damian Garside

      \

      I would agree with those posting here who know and have suffered from ulcerative collitis.I had a friend who went to a conference in Spain (from South Africa, not Britain) and had a serious relapse that came out of nowhere and put him in intensive care for weeks (wiped out his conference, needless to say).

      If funds are being withheld from the club to strengthen midfield when suddenly midfield players are collapsing with bad health (Fletcher, Hargreaves) or losing form (Carrick– until lately) or never finding it really (Anderson) then it is all a bit perverse. We import wingers and attackers going out of fashion — but nothing in the area where we have a `curse’: what does that say about a sense of balance going out through the window?

      And this lack of transparency and veracity is a huge problem. As supporters we play into this by defending Fergie when he behavies outrageously with the press, ignoring the obvious and pertinent questions thrown his way. As suppoerters we need to know what is happening at our club and this is being denied us.

      Anyway I hope Duncan can soldier through this and still have a effective career in football (at United).

      • http://www.unitedrant.co.uk/forum/profile/admin Ed

        Damian – that was exactly my point. The club gives one story, and now another. If medical privacy is the issue, why break that now? I’ve read some utter nonesense on the net talking about drug testing/steriods required to treat the disease. 1) is that really the treatment? really? 5-ASA ASACOL is not a steroid 2) has the club agreed no out of competition testing with the Premier League and WADA? Why are these details not being released.

        It’s the cloak and dagger that bothers me about this. Lack of transparency suggests there’s something to hide. I’ve every simpathy with Fletcher, it is apparently from everything I’ve read and the posters posting here) a horrible disease. That sympathy doesn’t mean the club has handled this perfectly. It hasn’t and there are questions to answer.

  • Wil

    Good Luck Darren and Vidic! You two have been fighters on the pitch for Utd. and I’m confident you’ll fight your way back.

    It is sad to hear two of our first team players is out for the season. This seriously makes our squad very thin.
    Rio will get his injury as usual and this means we will only have 3 young centre backs (Smalling, Jones & Evans). Evra hasn’t been playing well in defense and we hardly saw the Da Silva’s brothers play this year. Very worrying for our defense.

    I don’t need to say much about our midfield again but let’s hope Pogba and Morrison gets their chance this Christmas and that Cleverley will stay fit more often than not.

    Overall, we are having problems and I look forward to January and seeing what Fergie will or can do….! C’mon Utd!

  • madmax

    Whether he is able to play again is irrelevant. Just hope he gets better.

    • vlad

      +100500

  • Gopher Brown

    The bottom line is that there have been goings on behind the scenes that the club aren’t prepared to disclose to the fans (and the fans probably aren’t entitled to the information anyway).

    Any number of things could have happened to result in this outcome, for example, his condition may have been managed by steroids for the last 6 months, but the FA/UEFA/FIFA have been in touch to say that the steroids are a banned substance in all circumstances, hence he can’t play any more.

    It might be that the FA/UEFA/FIFA originally gave special dispensation to Fletch to use a banned substance, only for their permission to be recinded.

    Your post suggests you are blaming the club for putting him at risk, but there may be a lot more to it than that.

  • Swapnil

    the biggest question for me is if the club knew about the severity of fletcher’s condition,how on earth did SAF plan to enter the new season with only anderson,carrick,giggs(38 yr old) and cleverly(without a single full season at the club) as the only CM players available to him?????????????i mean even if fletcher was fit we needed new CM.its a joke to me….

  • sidney

    What was wrong with my title ffs

  • sheesh

    If anyone needs a good number 2, it’s Fergie.

  • baggio365

    Ed said:
    Damian; that was exactly my point. The club gives one story, and now another. If medical privacy is the issue, why break that now? I`ve read some utter nonesense on the net talking about drug testing/steriods required to treat the disease. 1) is that really the treatment? really? 5-ASA ASACOL is not a steroid 2) has the club agreed no out of competition testing with the Premier League and WADA? Why are these details not being released.

    Ed the medical treatment and management of this condition is a separate issue. UC can be treated with steroids, it can be treated with non-steroidal anti-inflammatory agents and it can be treated with immune-modulators. and lastly with surgery. it all depends of the severity of the condition. thats a decision made by doctor’s. FIFA/WADA have no say in that at all. Their jurisdiction is purely whether or not a player is allowed to use certain medication for certain conditions, and again its decision made by medical staff who work for these organizations, not bureaucrats with no/limited medical knowledge.

    I can’t answer why the club has decided to come public now, but that probably has a lot to do with fletcher than the club itself. fletcher has the right to privacy. if he didnt want the world to know what was going on for the last 8 months that’s his call. the club would have played along. obviously now the disease has progressed and he needs an extended break from football, so he has made the decision to be open about it.

    i highly doubt his medical staff would have let him play in the last 6 months if they felt his disease would be adversely affected by playing. it was obviously something they felt had been controlled, but has now worsened.

    i dont think the club can be blamed for any of the above. IBD/UC isnt like a torn ligament. management of it would be by specialist gastroenterologist, people who would not be on the clubs payroll.

    now on the other had, the club knowing full well of fletcher’s condition should really have planned for the disaster that is our central midfield. that is negligent from a footballing perspective, and the blame should lie with fergie.

  • http://www.unitedrant.co.uk/members/danniitronix/ danniitronix

    Great post, blame lies with fergie-phelan-gill for failing to plan for this know risk. The consequences have been far reaching with us being forced to keep giggs, play an out of form park and move rooney to the middle when his form was so good. Rooney faces the risk of being inured / burnt out. Jones is in the same boat. Even so this weakness is enhanced by refusing to promote the youth of morrison and pogba at the cost of jones and rooney – and 20m per year.

  • Alfonso Bedoya

    danniitronix said:
    Surely this is also the fault of the Glazers?

    If it was worms, or some other intestinal parasite… maybe.

    But irritated bowel?

    That sounds more like you.

  • brianofnazareth

    Alfonso Bedoya said:
    If it was worms, or some other intestinal parasite… maybe.

    But irritated bowel?

    That sounds more like you.

    Oh! Shit just got real….

  • Ichiro

    “Levein also revealed that Fletcher has endured a long-term battle with colitis, stretching back to his early twenties.

    He said: “He has had this for nearly four years now, he’s been pushing himself, and he’s really suffering it this time. “

    http://www.telegraph.co.uk/sport/football/teams/manchester-united/8992272/Manchester-United-midfielder-Darren-Fletcher-may-make-earlier-recovery-than-expected-from-bowel-condition.html