Irritable Bowel Syndrome Message Boards | Today's Doctor Appointment

Well, I saw a new GI doc today for a second opinion. I almost came late because of a BM, but luckily the hospital is 3 blocks away from my dorm, so it wasn't too bad. Here's how it went down.

After a nurse took all the relevant vitals (and returned my wallet which I had left by the scale), the doctor came in. A few basic questions about school and such, then down to business. Started with some questions about why I came. Asked me to describe my symptoms, and told me to clarify what I was saying to make sure she knew what I was talking about. She then asked about medical history, how long have I had these problems, any problems dating back to high school or before, etc.

Then, we moved into some more specifics. What am I eating, how often am I eating, do any foods make my symptoms worse, how often do I have a BM, what's the conisistency of the BM or does it vary, are the BMs concentrated in a certain time of day or random, and so on. The questions part went on for quite a bit, and I was glad to see that she was being very thorough about it to make sure we were both on the same level. I commend her also for asking if I'm an Ashkenazic or Sephardic Jew (there are genetic disorders that are common specificially to Ashkenazic Jews like Tay-Sachs).

After reviewing my x-rays and blood work, she felt my stomach and did a rectal exam (my third since August. Argh.) When all that was over, she said that I definately presented as IBS, but it's not clear if I'm really C or D, because I'm having 5-6 or more BMs a day, but they're hard to get out, so it's really neither. Her reccomendation was to put me back on a SFS, but Citrucel caplets this time instead of Metamucil powder, starting with 2 caplets and working up to 4-6.

She also wanted me to add more fiber, like bran and leafy veggies (so, essentially, IF) to my diet to help my BMs form more consistently instead of ranging from pellets to mush (sorry, TMI). I happened to have a copy of Heather's color-coded food list with me, and I showed it to her to ask if it was a good idea to follow. She said that triggers vary from person to person, but overall it wasn't a bad guide. She gave me a list of foods and their SF and IF contents so I would have a better referance for quantities.

While she was pretty sure I'm IBS, she recognized that there are still other possibilities, so she wanted to focus on diet regulation and bathroom habits first before moving to "real" treatment. To that end, she said that I should never continue with a BM past 5 minutes unless it's still coming, but if I only have a "feeling of incompletion" (my words) I should get up and if neccessary come back, but not to force myself to continue.

As for testing: She's going to have me do a "marker" x-ray, where I swallow some markers (like pills) on Friday then get an x-ray on Monday, Wednesday, and Friday to see where they are. This might show if I really have a bowel issue or merely a motility problem. Only if that shows something will she consider barium or something I think she called "defacotomy." But the marker x-ray first.

In short, I was very impressed with her thoroughness and her processes and her acknowledgement that it could still be something else besides IBS. Very, very happy with her (and much more than my previous GI). So if you're in the Philadelphia area, call Presbyterian Hospital at the University of Pennsylvania 215-662-8900, but be warned that 1) You'll have to pre-register into the HUP health system, and 2) It can be a long time before they have an opening for an appointment.

Thanks for reading, everyone!

Avidan

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Why'd you have to go and make me so constipated?
--'Weird' Al Yankovic, "A Complicated Song"

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