Doctor Won't Help Me With Stomach Issues

[ThaiPauly]

Recently I contracted Divictulitis  and was hospitalised at CMR. They did a CAT Scan which revealed the problem. After 2 days I was discharged with anti-biotics.

 

The pain all but disappeared but then a week ago I started to get pain again, not in the same area of my stomach but pain all the same.

 

It woke me at 3.30 this morning as it does most mornings now.

 

I tried to make an appointment to see my gastro doctor but a nurse rang my wife back and said that the doctor said he cannot help me as my problem is all sycosamatic ' and  need to see the physicatrist even though the CAT scan report says that "further endoscopic examination after inflammation is improved advised". It says this TWICE in the report, but the second time it mentions it it says " If clinical susecious (I think this is a spelling mistake) for colonic tumor further endoscopic examination after inflamation is improved" Obviously any mention of the word tumor is very worrying .

 

I refuse to accept this, pain is pain, I have not been able to leave my house for 10 days now and it is obviously getting me down, but that is not causing my pain.

 

I am now trying to heal myself. I may well have a leaky gut from what I have read so I am eating everything I can find that is organic or fermented, plus Chia seeds Vitamin C and fruit shakes. I am trying to stay off painkillers as these can disturb the gut.

So should I seek out another hospital for another colonoscopy or press my doctor further?, but I really am disappointed with him, he obviously is not taking the time to read my notes as he was in America when I had the CAT scan done and was in hospital

 

Your thoughts or if you have had any similar experiences would be appreciated.

 

Thanks

TP

Edited June 27, 2018 by ThaiPauly

[ezzra]

7 minutes ago, ThaiPauly said:

So should I seek out another hospital for another colonoscopy or press my doctor further?

Yes, as soon as you can, go to any of BKK big hospitals and let them eximin you all over again, yes' it's not cheap but it's your life and health we're talking about here..

[Briggsy]

Did the doctor really say you need to see the psychiatrist?

 

We have a chain of communication Doctor --> Nurse --> Your wife --> You. This chain also possibly involves a language switch.

 

I am not confident the message did not get lost along the way. How did your wife express the term 'pyschosomatic' in English?

 

Anyway, there is a longstanding tradition in Thai medicine of unwillingness to treat untreatable, difficult to treat or chronic conditions. This goes back to the days when doctors were only paid if the patient got better.

 

If the doctor won't see you for whatever reason, see another. Plenty of them to take your money here.

[ThaiPauly]

20 minutes ago, Briggsy said:

Did the doctor really say you need to see the psychiatrist?

 

We have a chain of communication Doctor --> Nurse --> Your wife --> You. This chain also possibly involves a language switch.

 

I am not confident the message did not get lost along the way. How did your wife express the term 'pyschosomatic' in English?

 

Anyway, there is a longstanding tradition in Thai medicine of unwillingness to treat untreatable, difficult to treat or chronic conditions. This goes back to the days when doctors were only paid if the patient got better.

 

If the doctor won't see you for whatever reason, see another. Plenty of them to take your money here.

Yes he did. When I was admitted in March with stomach issues he did a colonoscopy and an endoscopy and because he could not find anything he referred me to the psychiatrist who put me on methadone, which was a big mistake and led me to be hospitalized again, but that's a different story

[Jessi]

Paul, You have been in Thailand long enough to understand Thai Doctors????

Get away from this Dr and quick. Wait for Sheryl to come on as she will have the best Gut Dr name but it may be a trip to BKK.

Get well soon Paul.

[ThaiPauly]

Just now, Jessi said:

Paul, You have been in Thailand long enough to understand Thai Doctors????

Get away from this Dr and quick. Wait for Sheryl to come on as she will have the best Gut Dr name but it may be a trip to BKK.

Get well soon Paul.

Thanks Jessi, Sheryl has already given me the names of eminnant gastro doctors from another thread I was involved in when I had my first set of stomach issues three months ago, but  I recovered enough that I did not think it would be necessary to go, now things have changed and that might be the only option left, but as I said in my first post I am trying all sorts of herbal  and organic food, stuff I have watched on youtube from a doctor called John Bergman who has a lot to say on the subject and not a lot of good things to say about doctors.

[Sheryl]

Absolutely you should change doctors. Permanently.

 

 Get all your records including the gastroscopy and colonscopy report (with pix if they cannot supplky CD)  and CD of the CT to bring with you.

 

Also please post them here along with clear description of the abdominal pain you re having: where exactly on the abdomen it is (draw a picture if that helps) and what it feels like, and anything that seems to make it better or worse (e.g. does eating make a difference?)

 

I am quite confused by your statement that you were diagnosed with diverticulitis when in prior thread (https://www.thaivisa.com/forum/topic/1022816-stretta-for-gerd/?page=4 post #51) you said the diagnosis was Crohn's Disease. Can you please clarify this, was Crohn's then later ruled out and a new diagnosis made?? By whom based on what tests?

 

It makes considerable difference to whom I would suggest you consult. 

 

Also in future please include link to prior threads if they contain relevant medical history, and avoid the term "stomach pain" when talking to doctors. That has a very precise meaning and is in no way synonymous with abdominal pain.  Always describe pain clearly in terms of where it is on the abdomen. For that purpise we imagine the abdomen has having 4 sections formed by drawing straight lines horizontally and vertically through the navel. That results in a Right Upper, Left Upper, Right Lower and Left  Lower quadrant. 

 

Also please clarify if you were ever tested or treated for h. pylori, since you had (?still have?) chronic gastrits.

 

[ThaiPauly]

Hi Sheryl,

 

Thanks for your response.

 

I don't have h pylori this was shown on a surgical pathology report that I had done at the end of February.

 

Chrohns Disease was a pure guess by the Doctor at Sriphat , turned out to be untrue when the blood tests and stool samples  came back.

I don't know if I still have gastritis, no further tests have been done, if the doctor had paid attention to what the CT Scan revealed then he would have done another endoscopy to clarify.

 

The diagnosis of diverticulitis was made after I was admitted to Ram( because I was in so much pain) after a blood test and a CT Scan, I was then put on a drip of anti-biotics for two days then discharged with 10 days worth of a/b's which included Fygel which I know is rough on the stomach. At this time I was out of pain and thought I would recover OK. When I saw my usual doctor for a follow up 10 days after I was discharged a new blood test revealed that the infection was no longer present, and the pains I have now are not the same as when I was admitted nor as severe.

 

It is difficult to isolate the pain to any particular section of my abdomen, it seems to move and be different. . Some days I have the runs , other days I don't.  I have completely changed my diet and am now drinking  home made blended juices in the day and either fish or chicken with organic veg. I am also  taking chia and pumpkin seeds. Eating makes no difference to my condition it is neither better or worse.

 

I have cut out all dairy, carbs, alcohol and coffee, I know that chocolate makes it a lot lot worse, I had a very low blood pressure reading last Friday, under 90, so I ate a bar of chocolate to spike it up, which worked but since then the pain has never gone away completely, prior to that I thought I was recovering well.

 

I hope this gives you enough information to start with for you to be able to help me, I really do appreciate the time you are giving me

Edited June 28, 2018 by ThaiPauly
Additional Information

[BritManToo]

Gallbladder infection (stemming from gallstones), often missed by doctors, goes away quickly after anti-biotics.

Comes back frequently (worse in the night when lying down) if the underlying cause (gallstones) is not removed.

Aggravated by heavily processed foods (flour, biscuits, bread, fried anything, fizzy drinks)

 

Usually spotted by the doctor operating the ultrasound equipment.

Did you try another course of antibiotics?

Did that stop the pain?

Edited June 28, 2018 by BritManToo

[ThaiPauly]

Nobody has suggested that it could be gallstones. I have been on one type of A/B's they are finished so I am not on anything right now. I will mention this when I find a new doctor. Thanks for your imput  BMT

[The Renegade]

12 hours ago, ThaiPauly said:

It woke me at 3.30 this morning as it does most mornings now.

Classic symptoms of a Duodenal Ulcer.

 

Not that I am suggesting that is what you have. You need to get to another doctor.

[Sheryl]

GB issue should have shown on CT.

 

From what OP says it is not at all clear what is going on. Could be a flare up of the diverticulitis ir could be irritable bowel syndrine

 

OP if you have not yet seen the Sripat dr I recommended then do so.

 

Re the chocolate has thst happened before? As if not the timing might be coincidental.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[ThaiPauly]

No, I have never had a problem with chocolate before.

 

I have seen the assc prof that you recommended at Shriphat, he's the guy who said I may have Chron's, he had no idea what was wrong with me.

 

I saw a specialist about 10 years ago at Bumrungrad,  he seemed very knowlegable  so I will find out if he is still there and take a trip if he is.

 

When the doc did the blood test on admission she was checking for one of two things, diverticulitis and IBS which I did not have 3 weeks ago. However I DO have Ulcerative Colitis, maybe I am having a flare up of that?, I have meds that I regularly take to control it, maybe I should tripple my dose which is what I have done in the past when I have had a flare up, I shall start that tonight.Although when I have had it before the symptoms were never this bad, but upping the meds can't do any harm.

[Bonobojt]

13 hours ago, ThaiPauly said:

Thanks Jessi, Sheryl has already given me the names of eminnant gastro doctors from another thread I was involved in when I had my first set of stomach issues three months ago, but  I recovered enough that I did not think it would be necessary to go, now things have changed and that might be the only option left, but as I said in my first post I am trying all sorts of herbal  and organic food, stuff I have watched on youtube from a doctor called John Bergman who has a lot to say on the subject and not a lot of good things to say about doctors.

I have watched John Bergman too on YouTube, but you said he was a doctor, he's actually a Chiropractor, Chiropractor's like to say they are Doctors of Chiropractic .....so just in case you didn't know, he's not a real doctor, but does recommend a organic plant based vegan diet to heal.

[Sheryl]

OK now I am totally confused as you clearly state in post #8 that Ulcerative Colitis was ruled out.

 

??????

 

And you also stated in your prior thread that colonoscopy results were normal/ This is never the case in UC, which is a chronic condition.

 

By the way there are no blood tests for IBS, it is a diagnosis of exclusion based purely on symptoms and no other evident cause.  So you have never had a blood test for IBS and it has not been ruled out. What it sounds like happened at your last admission was that CT plus blood test led to diagnosis of diverticulitis so the pain was ascribed to that. As explained, an IBS diagnosis is made only when no other cause for persistant or recurrent abdominal symptoms can be found,

 

 UC and diverticulitis cannot be diagnosed by blood test either though blood tests can contribute to the diagnosis when combined with other test findings.  For diverticulitis, CT findings plus blood test will usually clinch the diagnosis.  For UC specific changes in the bowel mucosa need to seen on colonoscopy and biopsy taken during endoscopy.

 

Diverticulitis is an inflammation/infection of diverticula. When healed you still have diverticulosis, it is a chronic condition, and future flare ups of diverticulitis are quite possible, even likely. Diverticulosis (presence of diverticula) will also show on colonscopy so again we are back to your having said the colonoscopy was normal.

 

There is an excellent colon specialist in Bangkok, Harvard trained, but he deals only with colon and rectum so I cannot be sure yet it is an appropriate referral. Also, before you see anyone, you need to get the story straight as no doctor will have the  to sort through all this contradictory stuff.

 

Again, I ask that you post the colonoscopy report. CT report also. The actual reports, do not extract from them. As well as anything ypu have from past diagnosis of UC if there was one.

 

 Re the chocolate, likely just coincidence. Whenever you get abdominal pain you will have eaten something the day before, doesn't mean that caused it. Whether you need to be observing any dietary modifications at all depends on what is wrong with you.

 

As this is going to take some time to sort through, if you want you could get the following blood tests at a lab:

 

1. CBC

2. ESR

3. C-reactive protein.

These will show whether there is an infectious or inflammatory process taking place.

[Sheryl]

11 minutes ago, Bonobojt said:

I have watched John Bergman too on YouTube, but you said he was a doctor, he's actually a Chiropractor, Chiropractor's like to say they are Doctors of Chiropractic .....so just in case you didn't know, he's not a real doctor, but does recommend a organic plant based vegan diet to heal.

Please cease and desist posting quack videos and references to the advice of quacks. Which Bergman most definitely is. (plant based diets are indeed healthy. But they do not "cure" the diseases he claims they do.)

 

YouTube is not a viable source of medical information.

[Lacessit]

Maybe a silly question, but have you had your appendix removed? The symptoms are similar to a grumbling appendix.

The worst thing you can do for diverticulitis is eat anything with seeds in it, because the diverticuli are where the seeds

accumulate.

[lopburi3]

11 hours ago, Lacessit said:

The worst thing you can do for diverticulitis is eat anything with seeds in it, because the diverticuli are where the seeds

accumulate.

From my reading there is no scientific evidence to support that - although know it has been common advice for decades - and in fact eating foods with seeds may actually help prevent attacks.

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/diverticulitis-diet/faq-20058333

[Sheryl]

The main dietary recommendation for diverticulosis is high fiber diet.

No reason at all to avoid seeds etc. Pure myth. Fecal material within the diverticula sacs leading to infection primarily occurs because the bowels are not emotying as regularly and fully as they should.

During attacks of diverticulitis it may be necessary to rest the bowel and either not eat or eat only very low residue foods but that is only until the infection and inflammation have resolved then back to high fiber.

Please let us now get back on topic and stop dispensing advice -- factual and unfactual -- on the management of conditions the OP may not even have.

His situation at present is that he lacks a clear dagnosis.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[Sheryl]

P.S. There is also no such thing as a "grumbling appendix". Appendecitis was certainly ruled out in his recent hospitalization so not the cause of that bout of pain. Nothing he has said about this current bout of pain raises alarm bells in that direction but as no tests have been performed yet and he has not yet been examined by a doctor cannot rule anything out. While there is good chance his current pain episode is telated to the prior one for which je was hospitalized, it is also possible that it is something entirely different.


Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[Lacessit]

Just now, Sheryl said:

P.S. There is also no such thing as a "grumbling appendix". Appendecitis was certainly ruled out in his recent hospitalization so not the cause of that bout of pain. Nothing he has said about this current bout of pain raises alarm bells in that direction but as no tests have been performed yet and he has not yet been examined by a doctor cannot rule anything out. While there is good chance his current pain episode is telated to the prior one for which je was hospitalized, it is also possible that it is something entirely different.


Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

Sorry, Sheryl. I have to disagree with you on this one. I had a grumbling appendix for 3-4 years. When the surgeon removed it, it was half necrotic.

Medicos don't know everything. In this case, I am preferring my personal experience over your medical opinion.

[Sheryl]

Sorry, Sheryl. I have to disagree with you on this one. I had a grumbling appendix for 3-4 years. When the surgeon removed it, it was half necrotic. Medicos don't know everything. In this case, I am preferring my personal experience over your medical opinion.

 

You did NOT have a "grumbling appendix". There is no such condition. 

You apparently had appendicitis which went untreated for sometime leading to necrosis. You are lucky it was detected and removed before it ruptured causing peritonitis.

 

Your personal experience does not qualify you to create and name a new medical disorder and nothing you describe suggests you had anything new/unknown to medical science.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

 

[Lacessit]

Just now, Sheryl said:

You did NOT have a "grumbli g appendix". There is no such condition.

You apparently had appendicitis which went untreated for sometime leading to necrosis. You are lucky it was detected and removed before it ruptured causing peritonitis.

You

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

So appendicitis that goes untreated for 3-4 years ( periodic flareups of abdomen pain ) is not a grumbling appendix.

Then what would you call it, apart from medical negligence. Diagnostic incompetence?

[Sheryl]

It is (was) appendicitis leading to necrosis. And yes, failure to identify it over a period of 3-4 years was a diagnostic error. Whether it would qualify as "medical negligence" or reflect "diagnostic incompetence" would depend on whether appropriate tests and examinations were done in a timely manner, their results and whether there was any other co-existing condition that might have accounted for test findings and thus confused the picture. None of which do I know.

 

Proper procedure for suspected appendicitis is to start with an abdominal ultrasound. If this shows appendicitis no further imaging is needed as the specificity of this finding (likelihood that a positive finding is correct) on ultrasound is high. If however the ultrasound is negative -- or if it was unable visualize the appendix as sometimes happens -- then CT should done as this has a much greater sensitivity (likelihood of giving a positive result if the disease is present). CT is in effect the "gold standard" for diagnosis but to reduce costs and unnecessary radiation exposure ultrasound is usually done first and CT reserved for cases where the US was negative or could not adequately visualize the appendix.

 

The OP had a CT done during his last hospitalization. Assuming it was correctly interpreted, appendicitis was ruled out at that time. This does not mean it can be ruled out now, of course, though the index of suspicion based on his description of the current pain is low.

 

He has been advised to get a CBC which would shed further light.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[Lacessit]

Perhaps we can agree on another term such as chronic appendicitis. Bear in mind this happened nearly 60 years ago, and I don't know what level of abdominal ultrasound expertise was around then. The surgeon simply asked me to breathe out, smelled my breath, and from there I was whipped straight into the operating theatre. I had been doing a lot of medicine ball crunches, and he said afterwards my muscle wall in that area was like trying to cut through iron.

[ThaiPauly]

18 hours ago, Sheryl said:

OK now I am totally confused as you clearly state in post #8 that Ulcerative Colitis was ruled out.

 

??????

 

And you also stated in your prior thread that colonoscopy results were normal/ This is never the case in UC, which is a chronic condition.

 

By the way there are no blood tests for IBS, it is a diagnosis of exclusion based purely on symptoms and no other evident cause.  So you have never had a blood test for IBS and it has not been ruled out. What it sounds like happened at your last admission was that CT plus blood test led to diagnosis of diverticulitis so the pain was ascribed to that. As explained, an IBS diagnosis is made only when no other cause for persistant or recurrent abdominal symptoms can be found,

 

 UC and diverticulitis cannot be diagnosed by blood test either though blood tests can contribute to the diagnosis when combined with other test findings.  For diverticulitis, CT findings plus blood test will usually clinch the diagnosis.  For UC specific changes in the bowel mucosa need to seen on colonoscopy and biopsy taken during endoscopy.

 

Diverticulitis is an inflammation/infection of diverticula. When healed you still have diverticulosis, it is a chronic condition, and future flare ups of diverticulitis are quite possible, even likely. Diverticulosis (presence of diverticula) will also show on colonscopy so again we are back to your having said the colonoscopy was normal.

 

There is an excellent colon specialist in Bangkok, Harvard trained, but he deals only with colon and rectum so I cannot be sure yet it is an appropriate referral. Also, before you see anyone, you need to get the story straight as no doctor will have the  to sort through all this contradictory stuff.

 

Again, I ask that you post the colonoscopy report. CT report also. The actual reports, do not extract from them. As well as anything ypu have from past diagnosis of UC if there was one.

 

 Re the chocolate, likely just coincidence. Whenever you get abdominal pain you will have eaten something the day before, doesn't mean that caused it. Whether you need to be observing any dietary modifications at all depends on what is wrong with you.

 

As this is going to take some time to sort through, if you want you could get the following blood tests at a lab:

 

1. CBC

2. ESR

3. C-reactive protein.

These will show whether there is an infectious or inflammatory process taking place.

Sheryl,

 

I cannot see in post 8 any reference to ulcerative colitis. I know that I have it so as I cannot attribute my problem to anything else right now I am just assuming that it is possible that I am having a flare up.

 

I have uped my dosage of meds as I have done in the past and this morning was the first day I have not been woken by the pain. Today is so far a good day, things may be taking a turn for the better.

 

As for my story being confusing...yes it is very  confusing for me too. I have been in hospital multiple times and apart from one hospitalization the doctor could not diagnose the problem and put it down to stress, now my doctor does not want to see me only adds to my confusion which is why I am posting here. I just don't know what's wrong with me and nor do the medical profession

 

I don't want to post all my results on the forum so if you can send me your thaivisa e-mail address I will scan them all and send over.

 

Maybe things are improving now though.

 

Thanks for all your help,

 

PAUL

[Sheryl]

I don't havea TV email. Please send by PM

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[ThaiPauly]

10 minutes ago, Sheryl said:

I don't havea TV email. Please send by PM

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

Sheryl,

 

I have decided that I really don't want to bother you with pages and pages of test results. I have made an appointment to see my local doctor tomorrow who is very highly regarded here in CM (Dr.Morgan) and I will take everything to her.

I will also ask her to do the blood tests.

I will post the results on here.

 

Thank you for your time and patience, it's not easy dealing with me and my health issues

[xylophone]

5 hours ago, Lacessit said:

I had a grumbling appendix for 3-4 years

That was a very common term when I was a kid, but as Sheryl said it was a "misnomer" and although in those days even a doctor might use the term (mainly not to confuse the patient) it was/is chronic appendicitis and operations for this in those days seemed quite common!

 

Grumbling appendix is an old term used to describe chronic appendicitis. Chronic appendicitis shares many qualities with acute appendicitis, which is the more common of the two conditions. Both involve the inflammation of the vermiform appendix resulting in pain and discomfort in the lower right quadrant of the abdomen. The difference between the two is that acute appendicitis requires immediate medical intervention and removal of the appendix, whereas chronic appendicitis does not. Rather than the sudden, excruciating pain associated with acute appendix problems, grumbling appendix pains occur gradually.

[simoh1490]

2 hours ago, ThaiPauly said:

Sheryl,

 

I have decided that I really don't want to bother you with pages and pages of test results. I have made an appointment to see my local doctor tomorrow who is very highly regarded here in CM (Dr.Morgan) and I will take everything to her.

I will also ask her to do the blood tests.

I will post the results on here.

 

Thank you for your time and patience, it's not easy dealing with me and my health issues

Paul, it's your decision as to what to do next but taking all your test results to a generalist family doctor rather than any of the GI specialists in town makes absolutely no sense to me. I would have thought your better options might be to consult with an alternate GI specialist since that is almost certainly the direction that your GP will steer you, your options on this front include Dr Jeerasak at Rajavej who is supported by Dr Kanika plus one or two very carefully selected options at Sriphat.