By Alyssa Mango
As a patient suffering with digestive problems, it has been a struggle to manage my health between random episodes of searing abdominal pain. Even with the 4 years of experience I have working in an emergency department, it hasn’t been easy.
Modern resources for acute digestive problems leave many like me hopeless and with several questions unanswered. According to the National Institute for Diabetes, Digestive, and Kidney Diseases (NIDDK), an estimated 60–70 million people in the US suffer with digestive symptoms or diseases, accounting to 10–20 million annual visits to the emergency department (ED) for acute symptoms or exacerbations. Many are left constantly suffering with stomach pains, uncomfortable bloating, constipation, diarrhea, or vomiting, depending on their condition.
These symptoms can start seemingly without a trigger, even if a potential trigger exists, because it is very often a complex task to actually find the trigger.
I’ve heard the saying that healthcare workers sometimes make the worst patients. We try to “tough it out” and end up delaying getting help for our own health problems. As a person with 12 hour shifts in the ED every day, spending even more time there for treatment was less than appealing. I quickly saw that urgent care was my last resort and go-to option that I was comfortable with if I needed it.
My worst and most recent episode, though, back in February, left me begging for the ER. The intensity of the abdominal pain was indescribable. After eating a seemingly normal, vegetarian diet that day and the day prior, suddenly without warning I was in severe pain late at night while working on my computer. No matter what I did to help it, nothing worked, including over the counter medications to stop the pain and remedies I heard from others that could have worked. I went through a mental log of everything I ate or did over the days prior, but no matter what I did to figure out what triggered it, I was left dumbfounded and confused. All I thought was that whatever I had eaten had to be a mistake — but why?
How can someone classify eating a healthy diet as “a mistake”? For me and others like me with digestive problems, that’s what it can often feel like when our symptoms start right after a meal. For some people like me, it’s in response to a trigger, even though both me and my doctors are still looking for answers. For others, they can suffer at random times or, like most, even constantly every day. We feel punished by something that most people find enjoyable and necessary for sustenance. I can say confidently that my quality of life has been significantly diminished by my discomfort.
What is the digestive dilemma?
When I went to the ED, they only could put a band-aid on my digestive problems. Even after a battery of tests and imaging, unfortunately, they were only able to treat my symptoms, and only temporarily. They gave me Zofran for the nausea, an IV for the pain, and threw in some Pepcid hoping it will help. The medications they gave me quickly wore off when I was home, but the problems still lingered. As a patient and also a healthcare worker in the ED, I understood that it is their job to get me better and back home as quickly as possible. However, despite my acute symptoms, I still had a chronic condition that left me with more questions than answers, and I fear having to go to the ED again in the future.
Now what happens?
Patients like me are often left with a temporary solution to a problem they don’t understand. My diagnosis was “gastritis”, which simply means gastrointestinal pain. I knew I was experiencing gastritis — that part was obvious without an eight-hour stay overnight in the ED. The problem I also knew was that I would not be cured until I could find the cause.
The hospital referred me to outpatient treatment and off I went. I was discharged knowing just as much as I did before I arrived. My recent experiences with outpatient GI treatment is that without knowing the true cause, I felt that they would continue to band-aid the problem.
For symptoms like mine which are non-specific, most final GI diagnoses for root causes are made on the basis of endoscopies and colonoscopies — — but it’s not fool-proof; some people are still left undiagnosed or misdiagnosed. These are the realities that were explained to me by my doctor and which I knew from my own work. I knew that bowel prep would be at least a few days or a week long ordeal for me, and that I would have to arrange insurance and time off for me to make it to my appointment, and even then I am worried that the bowel prep itself could be a potential trigger. I also feared that the test would not shed any light on my problem.
Where does this leave patients?
I personally have seen patients return multiple times to the emergency department, with the same pain and symptoms as before, as I had felt. Until a solution is found for more accurate diagnoses, people will continue to be in and out of hospitals for emergency treatment of their chronic conditions that may never get to the root of the problem.