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Dr won't refer me to specialist

Hi,
I was hoping you could help with advice on a Crohn's diagnosis.
I have a history of abdominal trouble and despite recently requesting to see a specialist for a diagnosis to get to the route of the cause, my GP tends to be restricted to just treating the symptoms. I was told that referrals to hospitals were difficult and often get rejected.

The majority of Dr's diagnosis since my teens have been for gastritis, constipation, stomach bugs, piles, fistula, fissure, stomach ulcers (although they didn't send me for a test), inability to produce alcohol dehydrogenase enzyme (again pure verbal diagnosis and not sent for a test to back this up), however I've only been referred once for a sigmoidoscopy (where the fistula was found).

Most of 2011 I had numerous visits to the dr due to rectal bleeding.
Often going to the toilet to pass pure blood and dark clots.
There was an incident of being out to dinner and when getting up to leave found blood all over seat from rectal bleeding. Was so distressing!
Bowl movements ranged from pure blood, to soft stool mixed with mucus, pus, pure mucus, lumpy diarrhea. I had pain in my stomach when eating and as a result weight loss as I didn't like eating.

Often the GP I see is never the same, and very rarely do they read my notes, so won't be up to speed on any historical symptoms which I am aware of.

My partner has UC, and when I was most recently ill he became concerned at the frequency of my random fevers and abdominal pains and did some research. Based on my history I think I may have Crohn's, however I'd like to either rule this out or make changes to prevent the frequency of being ill.

I feel totally lost for what to do if my GP won't help.
 
I'm in the UK and I have changed doctors this week. I'm just worried I'll be fobbed off again. I don't know what the criteria is to be referred to a specialist and I now feel a bit embarrassed to ask again after my last doctors attitude.
 
I think your symptoms require further investigation most definitely. I agree with the other guys, Id go to a&e if your experiencing rectal bleeding. With your symptoms id be shocked if you didnt see a Gastroenterologist or at least be refered to one. Best of luck!
 
I'm in the UK and I have changed doctors this week. I'm just worried I'll be fobbed off again. I don't know what the criteria is to be referred to a specialist and I now feel a bit embarrassed to ask again after my last doctors attitude.

Don't be embarrassed, you fit the criteria by a mile. You need to see someone more qualified to get this straightened out, there's no question.
 
I would try the new GP practice. If one doctor won't refer you then ask for a second opinion. If you still have no joy tell them you will go to A&E and that you will tell A&E that you are having to use this service because the GPs have persistently refused to refer you to the proper service, and therefore you are having to use the emergency service inappropriately because of the GP.

You absolutely should have been referred to the gastroenterology or colorectal department by now. I cannot believe the arrogance of some doctors (I'm married to one - they're not all bad, and he is appalled by what has happened here).

Hopefully, by becoming a new patient at another practice means that someone will sit down and have a full review of your notes. Perhaps you could request a double appointment slot on the basis that you have a complicated history and need to discuss this fully with the doctor. Explain to the GP your worries about never having seen a specialist and that you feel your health is deteriorating because of this.

Despite your problems at the previous practice, try to be positive and communicative. You want them to be as sympathetic as possible and not see you as a problem patient. I'm sure you're not, but you want everyone to be on your side.

Best of luck, and let us know how you get on.
 
I haven't had as much rectal bleeding lately, it seems to be mainly bad abdominal pains and intermittent fevers and night sweats at the moment.

I really appreciate your advice so much.

Nitty - That's a really good idea about booking 2 appointments, I just hope the new practice will go for the idea as they may see it as taking potentially someone else's time. I have written everything down, so I don't get flustered too.

Fingers crossed I'll get some joy soon.
 
sounds like BS, by law, no one can deny you medical treatment, call the doctor and demand an appointment, if you ask if they are denying you treatment, tell them you will take them to court. doctors know the laws and will weasel around them to fulfill their own interests, do you know the laws?

this will scare the shit out of them, and they will then see you.

I've used this to push people around quite a bit, i never knew doctors would even try to push me around, you can use the laws to push them around too for your own interests!! your own well being.
 
I had similar trouble where my original Gastro Dr said it was a flare up of my Irritable Bowel and sent me away and said go home and you will get better overnight. So here is what I did. I was then given a diagnosis of Global Motility Disorder, so I simply googled that diagnosis specialist and found this amazing Gastro Specialist. That's what you need. Google is great and there are some really great Gastro specialist like the one that I have. He is great and he knew exactly what to do to figure out what was going on and not only did I have Crohn's but I have Colitis and Esophagitis. So eat up with inflammation. Please get rid of your current GP and found one that really cares. Please let me know what state you live in and maybe you can use mine! Hoping you can find answers.
 
I'm afraid I don't know the law and nhs procedure seems to be dependant on post code. When I had my most recent episode, I really wish I went straight to a&e, however I thought it best to go seek a referral instead. She gave me omeprazole and told me to come back after trying that for a month then she would reassess me for a referal. She also said that was the rules they now have to follow before a referal can be made.
I was on the tablets for a week and the pain in my upper abdomen was still there. Almost like a band of pain that would hurt in different points around that band. I was then prompted to make another appointment exactly a week after I last saw the dr as I had come down with a sudden bad fever and the pain had increased again.
The first thing the dr said to me was why am I back because I should have waited until after a month of being on the tablets. She seemed very off with me when I said I don't think the medicine is right as I'm still in pain. She said it doesn't work instantly.
I told her my toilet habits had changed and she just said I probably had constipation and wrote out a prescription for movicol.
I started to cry which I wouldn't normally do, but I was sitting there in pain and she didn't even check me. I asked again to be referred and she said that she wouldn't and it would just be rejected. She made no effort to console me and litterly trust the prescription at me and turned away so I'd leave.
I was in a real state when I got home and my partner called the surgery to complain. He was told the duty manager would call back but never did.
After that I registered with a new surgery.
I called for an appointment but they are fully booked until a week in ahead. I opted for a phone appointment on the Thursday just gone, but missed the call and therefore missed my slot. Ill have to either wait for a next available appointment in person or if I get bad again take the advice above and go to a&e. I just don't have faith in the nhs to diagnose something like this and believe they would rather palm you off with tablets for random symptoms rather than discover the route cause, unless you are near death, in which case they'll then take you more serious.
 
Have to agree with you about the NHS! I have long since learned to work the system as they say. I would strongly suggest going to A&E after hours - make sure it isn't when your GP surgery is open. Either that or wait till after 6pm and call NHS 24.
Most bigger hospitals will have an on-call GI. Try not to sound too demanding on the first visit - but if they send you away, wait a few days, if you feel worse go back. All you need is for one doctor to take you seriously. It also may make your GP sit up and take notice that you have been so bad to need to go to A&E.
I have never ever heard of a referral being rejected. As far as I am aware the referral may take months to come through for the initial appointment, but not rejected outright.
If you want to wait for the GP appointment, ask for a faecal calprotectin test to be sent away. This will measure your levels of inflammation. It used to be only the hospital that could ask for this, but now my GP can send it away without a problem. Hope someone listens soon. A little advice from what I've picked up in the parents section - document everything. Take pictures of the blood/clots, record your temp if you have one, etc.
 
Please don't write off the NHS. Every system has it's good and bad staff.

I went to see my GP after a few weeks of PR bleeding, and no other symptoms. She examined me and thought it could just be a small pile, but referred me on to the colorectal department anyway (non-urgent appointment) to be certain. Within 4 weeks I had been seen there and thoroughly examined (proctoscope) and given a provisional diagnosis of proctitis and some medicine to treat it, and referred on to the gastroenterology team for a colonoscopy. The colonoscopy (again non-urgent waiting time) was done 8 weeks later where my diagnosis was determined to be Crohn's disease. The next time I saw my GP her words were "Well, I really wasn't expecting that!".

All the staff were great and I can't fault the care I got. I know that others have their own horror stories, but they often are the ones that get heard more because people always speak out more when they have a complaint rather than when things go well.

I'm not here to blindly praise the NHS - it's not perfect. My point is that there are many great and caring doctors out there and you will eventually find the one who is best for you and who will get you the treatment you deserve.

A note about the GP booking system: Most surgeries split the allocation of appointments into slots that can be booked in advance, and slots reserved for 'emergencies' that can only be released on the actual day. Therefore if you phone the surgery FIRST THING on the morning you want to go, you should be able to be seen that day - just say that it is urgent. Depending on your symptoms you can perfectly justify not being able to wait another week or two to be seen. This was the way I got my first GP appointment that I mentioned above.

Keep positive. There are people out there who do want to help you, and you will find them soon.

You'll have to wait until Tuesday now anyway due to the Easter bank holidays, but try ringing up on Tuesday morning and let us now how you get on.
 
I hope my new doctor is as good as your nitty.
I've tried to get an emergency appointment again this morning and the new surgery's policy is to get the duty doctor to call you and assess if I need an appointment.
I just have to keep an eye on my phone all day as the only time frame I've been given is it'll be before 12pm.

In terms of health I still have pain in the mornings like I'm being stabbed in my back. My toilet habits are getting worse in terms of constipation, and if I don't go for a day I get really impacted. I was on the toilet for an hour and started crying from frustration and embarrassment for not being able to push it out. Sorry if that's TMI. When it did come out I felt like being sick, not sure if it was pain or just pure straining that made me feel like that.
The consistency was actually really dark and sticky... I went through the same thing a couple of days ago when I last went to the loo. I would have thought it would be hard and lumpy, but maybe I was just seeing the last portion of it.

I am so fed up. I've not been to work last week and off again today. I feel really down at the moment. Sorry for the moan.

*Update:
Spoke with the duty doctor on the phone. Earliest I can be fit in is Thursday morning.
 
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Don,t strain or push it doesn't,t help,up your fluid intake,if your mega constipated try a small piece of food and I mean a -small- piece of food that gives you the trots melon,strawberry,onion this was advice I was given by my clinic it does help but fluids really help.all the best
 
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