Gastroenterologist

[Brierley]

I've been plagued with gut problems for a long time, recently I've made a concerted effort to get to the bottom of them (no pun intended).

 

My biggest problem is distention, if I were female I could easily be mistaken for being 8 months pregnant. In the past year I've had one colonoscopy, two gastroscopies, one abdominal ultrasound and a series of blood tests. Today I was supposed to have a barium swallow test but it was cancelled at the last moment due to equipment failure. In the past I've also had a capsule endoscopy. 

 

The colonoscopy showed nothing untoward, a couple of polyps removed but nothing major. Past gastroscopies have shown GERD which is mostly asymptomatic plus minor evidence of Barret's. The ultrasound showed that gas obscures the views of the aorta and the pancreas but nothing other than that. The capsule endoscopy (now four years old) showed the capsule paused at 1 hour 45 mins for about ten minutes, before resuming its journey.

 

Biopsies show no evidence of IBD or Crohn's. My weight is constant, my diet is healthy and balanced, no alcohol, daily exercise. 

 

A three week course of diuretics proved interesting, my gut reduced quite a lot although ascites is not considered to be a factor, I believe this was just general shedding of retained fluids. Stopping all my meds for a month (doctors orders), (Statins, PPI and D3 supplement) produced no changes. The gut is a reasonable size first thing in the morning but expands as soon as I eat anything, fruit, toast, oatmeal whatever. Lactose intolerance has been ruled out.

 

It would be good to find a GOOD gastroenterologist in these parts, I've tried all the usual long standing suspects who seem to be in the business of ordering tests and curing the obvious. 

 

Any useful and helpful pointers will be gratefully received, particularly those for specialists that I may not know of, it is unlikely that those at CM RAM and Rajavej will be followed up on.

 

All recommendations for YouTube videos, homeopathic remedies and supplements and miracle cures, will be ignored.

 

Thanks

[Sheryl]

You do nto mention where in Thailand you are. Soundsl ike Chiang Mai?

 

In any case, from what you report of extensive effort having failed to find the cause, I think it is best you see this doctor in Bangkok, even if it means a trip:

https://www.bangkokhospital.com/en/doctor/asst-prof-dr-parit-mekaroonkamol

https://www.bumrungrad.com/en/doctors/Parit-Mekaroonkamol

 

(Same doctor, different hospitals.) He is  at Bumrungrad Friday evenings, at Bangkok Hospital on Sundays   only. He is also at Chulalongkorn (government hospital) but getting in to see him there requires going in person to make appointment and there will likely be a wait list, not so practical if one does not live in Bangkok - and also Chula is badly affected by the COVID crisis, many elective things on hold there.

 

In addition to being extremely well qualified (US trained, on faculty at a leading Med school and has taught at a prestigious US medical school as well) he has won accolades from several TV members for managing to diagnose conditions no other doctor could.

 

Obviously, bring the reports/CDs of all prior tests with you. I doubt there is any point at all to more scans, barium enema etc. I suspect you have either a motility disorder,  small bowel overgrowth (which can be bacterial or fungal) , an undiagnosed infection, or a food allergy.

 

Whether you want to travel to Bangkok right now with the COVID situation is another matter. I doubt you will get any further with this without it, but the situation does nto sound urgent.

 

 

[Brierley]

1 minute ago, Sheryl said:

You do nto mention where in Thailand you are. Soundsl ike Chiang Mai?

 

In any case, from what you report of extensive effort having failed to find the cause, I think it is best you see this doctor in Bangkok, even if it means a trip:

https://www.bangkokhospital.com/en/doctor/asst-prof-dr-parit-mekaroonkamol

https://www.bumrungrad.com/en/doctors/Parit-Mekaroonkamol

 

(Same doctor, different hospitals.) He is  at Bumrungrad Friday evenings, at Bangkok Hospital on Sundays   only. He is also at Chulalongkorn (government hospital) but getting in to see him there requires going in person to make appointment and there will likely be a wait list, not so practical if one does not live in Bangkok - and also Chula is badly affected by the COVID crisis, many elective things on hold there.

 

In addition to being extremely well qualified (US trained, on faculty at a leading Med school and has taught at a prestigious US medical school as well) he has won accolades from several TV members for managing to diagnose conditions no other doctor could.

 

Obviously, bring the reports/CDs of all prior tests with you. I doubt there is any point at all to more scans, barium enema etc. I suspect you have either a motility disorder,  small bowel overgrowth (which can be bacterial or fungal) , an undiagnosed infection, or a food allergy.

 

Whether you want to travel to Bangkok right now with the COVID situation is another matter. I doubt you will get any further with this without it, but the situation does nto sound urgent.

 

 

Many thanks Sheryl, I will see how and when I might manage a visit.

[IvorBiggun2]

14 hours ago, Brierley said:

All recommendations for YouTube videos, homeopathic remedies and supplements and miracle cures, will be ignored.

 

Have you been tested for H Pylori?

 

 

Quote

 

What will happen if H pylori goes untreated?

If left untreated, a H. pylori infection can cause gastritis (inflammation of the lining of the stomach). Gastritis can occur suddenly (acute gastritis) or gradually (chronic gastritis).

 

 

[Brierley]

12 minutes ago, IvorBiggun2 said:

 

Have you been tested for H Pylori?

 

 

 

Yes, several times. I'm pretty sure the problem is with the small bowel, Sheryl's' suggestions fit well, especially motility since I have lower disk/nerve problems. Also, the pause in the capsule endoscopy travels suggests similar. 

[ExpatOilWorker]

I am no expert on the subject, but I tried to go gluten free for 2 weeks and it helped a bit, as recommended in this thread. 

 

 

 

[4MyEgo]

7 hours ago, ExpatOilWorker said:

I am no expert on the subject, but I tried to go gluten free for 2 weeks and it helped a bit, as recommended in this thread. 

 

Thanks, I believe I have sorted it, e.g. over eating and heavy foods at night don't allow the gut to break the food down, so the back up  creates the gas which bloats me, suffice to say as I love food, not junk food, I mean real food, cooked by my lovely wife who has the hands of a chef, I have learned to have smaller portions, i.e. by taking half the food out of the plate and putting into another plate, why do I do this, well all of the times I have told her to put smaller portions, she just doesn't get it.

 

You have to eat Tiruk, you not like my food....LOL