Getting no help with stricture, Should I look for a new doctor?

[Astro27]

Sometimes I tend to take drastic steps too quickly so I need some advice to see if changing doctors might be a rational step for me.


I just recently had a colonoscopy two weeks ago, and for once I was excited about it because I've had a stricture causing extremely loud and unpleasant stomach noises for almost 2 years now. It's come to the point that I can't do basic things; I can't go on training courses for work, I can't go on dates, and meetings at work are an insanely anxious process - who really wants to be outed at work for being that weird guy who sounds like he's shitting himself? (that's what the noises sound like!)

I had read that during a colonoscopy they can do a baloon dialation which is often a highly successful treatment for strictures. I asked my doctor about this and he agreed and said we would do it during my next colonoscopy. I later called and checked again with his nurse because I wanted to make sure that part didn't get forgotten about, and she confirmed it was going to be part of the procedure.

So then as I'm about to be drugged up for my procedure I again ask my doctor and he replies something along the lines of "stomach noises are a part of Crohn's disease".....and here I am 2 weeks later in the exact same spot I was in before. I don't know if my doctor outright lied just to get me to come in,(I'm a bad patient), or he just forgot and didn't have the tools at the time.

Anyway, I don't know what to do now. I'm miserable and I've headed into a bout of depression I haven't been through for quite some time. Worst of all I don't know if I can even trust my doctor, either he's incompetent or a liar, which is worse? Or...as I mentioned earlier...maybe this is mostly in my head and there was a perfectly good reason for not doing the balloon dilation.

Any thoughts on what my next steps should be? I hate to think I might need another colonoscopy so soon from another doctor....but these noises are driving me crazy and seriously affecting my daily life.

 

[Justanothercp]

I know what you mean by the noises effecting everything! I remember being very anxious going anywhere in public because my stomach was obnoxiously loud!
I guess I would first talk with md and ask why balloon dilation wasn't done, when that was already agreed upon. If you don't get a solid answer, switch. You need to trust your md.
For the record, my stomach noises didn't go away until after my bowel resection.

 

[Lady Organic]

As patients we have rights. And it is in our right to have explanation of an exam/evaluation we have had. I wouldnt change doctor right away before I get further explanation. maybe your dr explained to you after the colonoscopy, but you dont remember because of the sedation? I'd call the nurse or dr and make an appointment to explain his report. Have a honest discussion and express your conserns. In the treatment section of the forum, most prolly some people can talk about this procedure and when it can be used. I am more likely to think that if it is available at your hospital as both dr and nurse said, your dr didnt perform it because you were not a case for it.

 

[UnXmas]

I understand the embarrassment of the noises. Some people would think it's silly to be embarrassed by stomach noises, but some noises just aren't the same as healthy peoples' stomachs rumbling from hunger. My stomach stopped making those noises when I got a stoma.

I've had doctors contradict themselves or not do what they said they'd do more times than I can count. But weirdly some of my best doctors make a habit of this. I've found that bad doctors will lie. But good doctors will forget, or change their mind and forget to fill me in.

One of my surgeons changes his mind all the time without telling me. Communication is really not his strong point. I've spoken to many other people who are his patients, and they agree - he kind of comes across as a bit autistic, in a world of his own - plus he's got that stereotypical surgeon arrogance, so he does what he thinks is best without taking much notice of his patients' views on some things. He doesn't explain surgeries. He told me I'd be having a certain type of stoma, then he changed his mind once he was operating and saw what was going on inside, and didn't bother to tell me, which led to confusion later. But he's a wonderful surgeon, and not just regarding his surgical skills - he listens to me far more than most doctors and he understands the effects my symptoms have on my quality of life and does all he can to minimise them (which should be what all doctors do, but as we know, all too many don't).

I also have a very good GP who is good at communicating, has a great "bedside manner", but forgets half of what you tell her and never has time to do the things she'd said she'd do. But she's the best GP I've had.

I guess you have to determine for yourself whether this incident means your doctor is not a good doctor. But if you change doctors, chances are you'll get one with problems of their own. Very good docctors are hard to find. I have another surgeon who's very good and doesn't forget things and certainly doesn't lie. But with the hundreds of doctors I've seen, that's very rare.

I would definitely ask for an explanation, maybe there was a misunderstanding, but don't be confrontational about it, don't accuse him of lying or anything; just say you were under the impression that a baloon dilation would be done during your colonoscopy and are wondering why it wasn't. But if it turns out he just forgot or, for some reason, decided it wasn't a good idea but didn't tell you, I wouldn't write him off if he's been a good doctor to you besides this episode. Just put your efforts into getting your stricture taken care of now.

 

[2thFairy]

Do you know for a fact that he didn't perform the dilation?

 

[shamrock15]

2th has a good question that is important. I have had balloon dilatations done and some didn't work for me. Was it written down somewhere that the dilatation was to be performed and under what circumstances? In Canadaa, before sedation is given you sign a paper outlining what procedure will be completed. If it hasn't been done as was agreed previous to the procedure and there wasn't a solid reason for not completing it, I would be knocking on the doctor's door for him to complete this at his expense. You had a reasonable expectation of its completion.

If you have browsed through here enough, you strictures can be very serious. It may also be possible that it is indeed more serious and he is examining other forms of treatment for you. See if you can get an appointment with him soon to find out what was accomplished and what he expects going forward. He certainly cannot leave a stricture untreated (it may be an increased monitoring schedule though) and you deserve to know how it will be addressed.

 

[Fernando1]

The technical term for stomach noises is borborygmus, see this link:

http://en.wikipedia.org/wiki/Stomach_rumble

I get them the loudest when the stomach wants to start digestion and is shifting looking for some content. I eat or drink about 6 times a day, at least 3 times I drink half a bottle of Ensure, this gets my digestion going in a gentle way. Try a
half bottle mid morning and mid afternoon, this will make the stomach busier.

However, watch out if this INCREASES your bowel sounds while it is processing it. In that case you may want to experiment with the timing of ingestion, maybe earlier when you are in private.

The other way I relax the bowel is with an antispasmodic pill (e.g. Donnatal, Hyoscimine) which helps with the distention and tightness in the bowel. Give this a try too.