# First ever appointment with a GI - what to expect/ask?



## heatherb (Feb 7, 2013)

Hi everyone

I just wanted a bit of advice really around GI appointments.

I've never been to see any form of specialist for anything (well, hearing but I was a kid) and have been referred by my GP to a GI for a consultation.

My main question is what to expect from that appointment and is there anything in particular I should ask?  I gather my GP will send all of my medical notes and blood/fecal results to the GI prior to the appointment so he'll have a background up to now.

What happens in the room?  Is it just like a repeat sort of appointment like with a GP?

Sorry if this is a really stupid thread to post, I was just thinking that I'm getting so caught up in what the GI will want to do, I'm not focusing on the appointment itself.  I know many people here have had several GI's - some good experiences and some not so good.

I'm just after some advice really or your thoughts in general about the process, and things to look out for so that I make the most of the appointment and don't forget something important.

Thanks again
Heather


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## UnXmas (Feb 7, 2013)

It's very much like going to a family doctor/GP in that they will talk to you about your illness, but be prepared that they may also carry out minor examinations. A GI may well want to feel your tummy. That's _usually_ all they'll do in an initial appointment, but if you're having rectal issues they may do a bowel examination (insert a finger into the rectum). You don't have to consent to that of course, and you can ask for a chaperone, but it's more useful if you can get it done if it's relevant to you.

They'll ask you questions about your symptoms and medical history - maybe a family history too, so be prepared with knowledge of any medical conditions your relatives have. 

I'm assuming you're not diagnosed yet? If so that will be the first stage. Don't expect a diagnosis on the day. Many will not even want to suggest possibilities. He will most likely refer you for further tests, and then discuss the results at your next appointment. If you are diagnosed, the discussion will centre on treatment and monitoring your illness. You can also talk about treamtent/symptom management whilst you go through the diagnosis process.

Most consultants seem to like to lead the discussion - they'll ask you questions rather than waiting for you to decide what to talk about. But they should give you a chance to ask your own questions also, usually at the end of the consultation. Don't count on him having read your notes or test results beforehand.

I have found that it is unhelpful to suggest to a consultant what I think is wrong or what tests I think I should have. This seems to make them think you are taking your illness more seriously than it needs to be. Be prepared that, with chronic digestive problems, they will almost certainly be considering the possibility you have Irritable Bowel Syndrome and that there is nothing serious wrong with you. An awful lot of doctors imply patients are hypochondriacs until the test results come in to prove otherwise. This will also depend on the nature of the symptoms you report to him. Hopefully this won't be an issue for you, but it's worth remembering that many patients get this reaction and it's not a reflection on you or the actual severity of your illness.

I think the only other thing is to expect him to run late. 

Good luck.


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## CrohnsChicago (Feb 7, 2013)

Hi there!

Your first appointment might make you a bit nervous, but don't fret, consider it the getting to know you phase. Along with some of the suggestions above, if you feel you may be too nervous, not sure what to ask or forgetful, it may help to note your symptoms and any concerns you may have on paper and bring it with you to the visit.

I personally don't think there is anything wrong with asking for additional tests especially if you have had lengthy discussions with your previous doctor and clearly a light has not been shed on your situation. You are going to need to learn to be your own advocate for IBD because no two people ever really experience the same symptoms and few follow the same treatment plan.

He will ask you questions about your history and symptoms, you will have a chance to ask him some as well. They may poke and prod a bit to check for obvious signs of illness but more likely than not He will order tests and pretty much take it from there.

Good luck on your appointment! Feel free to come back to this thread and let us know how it went


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## Lustforlife (Feb 7, 2013)

My first GI appointment was less than a month ago. The way it went was just a conversation about symptoms and ideas, as well as feeling on my abdomen for any sore spots or obvious signs of masses.

I think the best thing is to prepare and prepare. You waited for this appointment, and its fairly short, so you want to make the most of it and not walk away wishing you had brought something up. I highly recommend writing down a list of your symptoms, especially the ones that occur more frequently, but don't exclude anything else that is out of your normal. Research your symptoms, and suggest things you think it might be. Likely the GI is familiar with anything you bring up (but off chance maybe not...), and it will at least allow him to give you an explanation on why it could or couldn't be that. I brought up things like SIBO, Celiacs, Crohns, parasites, c diff, candida, whatever I could somewhat map to my symptoms. Research the tests that you think are going to be most valuable, and you can suggest those. For me, peace of mind was important, so if there's something in particular you want to rule in/out, push for those tests. (Also if you think it's crohns, maybe your symptoms can suggest where it likely is, ie. if you have constipation and not diarrhea it's more likely to be in your small intestine, and maybe a pill cam or MRI is more useful than a colonoscopy) just some ideas.

Best wishes for you!


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## heatherb (Feb 7, 2013)

Hi thank you all for the advice!

I just wasn't sure what to expect - the doctor has pushed for this, so I want to make the most of the appointment.  I'm hopeless for forgetting things, like I keep forgetting to tell my doctor about not sleeping properly at night and having cold sweats, to the point where I'm drenched.  I woke up this morning feeling gross, after having tossed and turned all night (weirdly I'm warm, but I sweat cold...!).

I will indeed make a list - I thought about this then I thought they might think I'm overdoing it and don't want to be labelled a hypochondriac on the first visit (seen quite a few threads where that is the case).  I'm just keen to get seen and hopefully sorted as I REALLY want to get on with my life and not spend more time with the toilet than I do my family and friends!! 

I get nervous and forget things, that's my problem.  Doctor-in-white-coat-syndrome haha.

Ah well, it'll be OK I'm sure.  I just hope he's nice! 

H


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## CrohnsChicago (Feb 7, 2013)

I get the sweats too when im flaring. you can't help but wake up cold when everything you are lying on is moist. lol

You'll be fine....just don't forget your list! 

Good luck heather! :hug:


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## UnXmas (Feb 8, 2013)

heatherb said:


> Hi thank you all for the advice!
> 
> I just wasn't sure what to expect - the doctor has pushed for this, so I want to make the most of the appointment.  I'm hopeless for forgetting things, like I keep forgetting to tell my doctor about not sleeping properly at night and having cold sweats, to the point where I'm drenched.  I woke up this morning feeling gross, after having tossed and turned all night (weirdly I'm warm, but I sweat cold...!).
> 
> ...


I still get nervous and actually tremble when seeing consultants sometimes! They're generally used to patients having some nerves though. Do you have someone to acompany you to the appointment? A friend or family member? They can also help remind you what you wanted to ask in case you do forget (though the list is a good idea too).

Don't worry to much about the hypochondriac thing. Although it is a problem that crops up a lot, it doesn't mean the consultation can't be beneficial overall. If it does appear the consultant is thinking this way, take it as reassurance that he doesn't think there's anything immediately serious is wrong. As long as he continues with the tests you need, it doesn't really matter if he's ordering them because he thinks he'll just make sure there's nothing wrong or whether he's ordering them because he's certain you have IBD (or some other condition). The result will be the same - you'll get the tests and get some answers. 

A consultant will be more likely to suspect Crohn's if you have symptoms like bleeding, fevers or weight loss. These are important things to mention if you are experiencing them. If you mainly have diarrhoea or some pain, it's harder to distinguish from IBS so he might be less likely to order invasive tests. Remember you can usually get second opinions anyway, so your future treatment doesn't all hang on this appointment - this is just one step in the process, and hopefully it will be a productive one.


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## Lustforlife (Feb 14, 2013)

Hi Heather - how are things going for you? Have you been trying to get on a cancellation list (if you're doing poorly)?


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## Lustforlife (Mar 1, 2013)

Hi again! I assume you've had your GI appointment at this point? How did everything go?


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## AlliRuns (Mar 1, 2013)

For my first appointment, I saw the resident first and he asked me about my entire medical history (related to my bowels of course), then I saw the attending and they did a quick exam and then discussed what tests they were going to do.


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