What Does a GI Doctor Do on the First Visit — part 2
Suggestions to see a GI doctor, what do you expect?
Welcome back to our second round to becoming a GI pro! I’m Angela Oi Chung, your trusty certified physician assistant with over ten years in the GI world. In the first part, I discussed the importance of honesty and preparation when visiting your GI doctor. This writing will dive into other details during your appointment and how to handle the diagnosis process.
Let’s start with the fun stuff — food. Do you believe that your gut is affected by what you eat? Well, you’re not alone! Many people find a love-hate relationship with certain foods can trigger the GI monster. That’s why, before your appointment, be a diet detective and record your “suspects” in a diary. The diary will give your GI doctors clues to narrow the list of suspects, like celiac disease, gluten intolerance, lactose intolerance, and irritable bowel syndrome. Plus, identifying foods that cause gassy and bloating pain can also be helpful.
Now let’s dive into the serious stuff. When you visit your GI doctor, bring a list of your medications and allergies. Please, please, please don’t say you’re allergic to medicine but can’t remember the name. If you genuinely forget the word, you should get some information from your primary doctor or at least recall the medicine’s purpose. Also, remember to bring pictures of your medications, so your doctor can quickly identify them.
Let’s talk about your past and present medical history. When you visit your GI doctor, bringing your health history, including any surgeries or illnesses you have had, is a great idea.
Don’t forget your family’s medical background, particularly any cancer running in your family. Luckily, you don’t need to remember every detail, but at least an approximate time frame can be helpful.
Okay, let’s talk about the awkward personal questions. Your GI doctor may ask about your history of rectal sex or if you use a rectal toy regularly, only if you complain of regular rectal bleeding and pain. Don’t be shy; it’s essential to answer truthfully because it can help your doctor determine the underlying cause of your symptoms.
Are you ready for your physical exam? It’s time for your healthcare provider to examine your belly. Don’t be alarmed if my hands are cold — it always happens. I’ll do my best to warm them up before starting. As an old-school practitioner, I was taught to begin by palpating (gently pressing) around the belly button. However, if your doctor starts elsewhere, that’s perfectly fine too. To assess different organs, I will assess all four quadrants, right upper, right lower, and left lower. Don’t worry; I won’t hurt you.
Now, for the moment of truth — diagnosis time. Unfortunately, a concrete diagnosis may not be immediately apparent in some cases. Your GI doctor may give you general medical terms like, non-specific abdominal pain, acid reflux, rectal bleeding, nausea, and vomiting, among other possibilities. Please don’t get frustrated, we don’t have superhero power with x-ray vision or a magic touch, and sometimes the correct diagnosis process takes time. Your doctor may suggest further testing, such as lab work, abdominal x-rays, abdominal ultrasound, CAT scans of the abdomen and pelvis, upper endoscopy, or colonoscopy, to help pinpoint the issue and provide a more accurate diagnosis.
Well, well, well, I know no one likes a needle, but a simple prick can get some basic idea of what is going on, especially to check your liver function. Blood work also ensures you’re not bleeding like a leaky faucet because of a low blood count. Don’t forget the stool test; yes, you heard me right! It helps to find the wrong guy, which caused you a week of watery diarrhea.
Next up, we’ve got the Abdominal X-ray. It’s like taking a selfie, but for your insides. And the best part? You don’t have to worry about getting too much radiation. Plus, you get to see your colon’s shape and ensure no obstruction in your pipes. If your doctor orders, you may need to drink that nasty oral contrast.
We’ve got the Abdominal Ultrasound if you want something more intimate. No radiation is involved, just some sweet, sweet sound waves. Ultrasound is suitable for detecting gallstones, gallbladder polyps, liver cysts, and even the size of your liver. But we can’t see your stomach or intestines, sorry folks.
Ah, the CAT Scan, the big boss of imaging tests. It’s like going on a magic tube to show all organs inside your belly but with much more radiation, especially with intravenous contrast. You need to have a good kidney function to entitle to have it done. We’re talking liver tumors, pancreatic cysts or tumors, and even the location of that pesky obstruction in your intestines. Unfortunately, CAT Scan is not great at spotting colon polyps or stomach cancer.
Now, if you want to get up close and personal with your colon, we’ve got the Colonoscopy. It’s like spelunking but in your butt. We’ll take a flexible scope with a camera and get all up to ensure no colon cancer. And if we find any polyps, we can remove them and do a biopsy to ensure everything’s normal.
Last but not least, we’ve got the Upper Endoscopy. Think of it as a deep dive into your stomach, with a little camera to capture all the sights. We can search for stomach ulcers, masses, polyps, and cancer. And we can grab some tissue cells to check for all sorts of fun stuff, like H.pylori (spoiler alert: it’s a troublemaker, I will write an article to introduce it to you), intestinal metaplasia, and cancer cells.
And if all that’s not enough for you, we’ve got a host of other tests, like the MRI, PET Scan, Endoscopy Ultrasound, Liver Scan (great for assessing your fatty liver), and Esophageal Manometry. Phew, that’s a mouthful. But don’t worry, if you’re interested in any of those, message me.
Make sure you schedule a follow-up appointment. And don’t forget to pick up your medication from a pharmacy.
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