GI has never ordered bloods or stool sample, is this odd?

[Kero]

So I have been seeing my GI for just over a year now. Through the whole time, she has been insisting IBS, I had a scope done on May 7th, and I have active colitis in my terminal ileum. The whole time I have seen her, she has never ordered bloodwork or stool samples, but insisted it was IBS. Is this odd? Even with me giving her the symptoms I have had, like undigested food, constant diarrheah (sp?) and mucus and blood in my poop. Should I maybe look for another GI? TIA

 

[24601]

I think it sounds odd to say the least. I would have expected bloodwork to be one of the first tests done to look for raised inflammatory markers. And with your symptoms I'd expect a stool culture to rule out enteric infection. IBS is a diagnosis of exclusion so I'd say making that assumption without doing those tests is negligent.

I'd find a new GI! Best of luck!

Just to check the findings from the colonoscopy - they saw inflammation in your terminal ileum? Did they take biopsies?

 

[Kero]

Yes, biopsies were performed, I have active colitis in my terminal ileum. approx 10 cms are affected. I don't see her again for another 3 weeks or so

 

[24601]

Have you got the results of the biopsies back yet? Were they negative for Crohns?

 

[Cross-stitch gal]

I started seeing my current GI in 2013 and at the time I began seeing him I was very sick. So, he was concentrating on getting me better. He never checked my bloods or stool samples either.

Last year I'd been reading about the Pentasa I'm on and that it should be regularly checked and happened to ask him about it at my visit. It seemed to dawn on him that he'd not done that on me yet and at that time I did have my bloods checked.

I guess what I'm saying is that it never hurts to ask. Sometimes doctors will forget and we might need to remind them. That's what happened to me.

 

[DEmberton]

I've never been asked for a stool sample, fortunately, but a basic blood test seems to be the first response when you see the GP for just about anything. They really should be checking if you are anaemic at the least.

 

[UnXmas]

Would this doctor have access to results of blood tests done by other doctors?

All my doctors - GP and consultants, including consultants other than gastroenterologists - seem to do constant blood tests. My gastroenterologists take stool samples (stoma output samples) when I'm in hospital. I did a couple of outpatient stool samples too.

My doctors have always led me to understand that blood tests are the first stage of diagnosis, and later of judging my overall state of health, before proceding to more specific, invasive tests. Regarding Crohn's, they check for inflammation markers and nutrient deficiencies, and stool tests for faecal calprotectin, presence of blood and signs of malabsorbtion. Because my weight is very low and I have an ileostomy, they've done a lot more stool tests than would be indicated for normal weight Crohn's patients, and patients without ileostomies, as ileostomies increase the risk of dehydration. Prior to diagnosis I had out-patient stool tests done to check for parasites I think.

I think it is very strange your doctor hasn't done blood tests. Even the doctors who dismissed me as having IBS did blood tests. They explained away raised CRP and other abnormalities, but they did do them. I've probably had hundreds of blood tests - literally. In hospital they do them multiple times a day.

 

[UnXmas]

I started seeing my current GI in 2013 and at the time I began seeing him I was very sick. So, he was concentrating on getting me better. He never checked my bloods or stool samples either.

Last year I'd been reading about the Pentasa I'm on and that it should be regularly checked and happened to ask him about it at my visit. It seemed to dawn on him that he'd not done that on me yet and at that time I did have my bloods checked.

I guess what I'm saying is that it never hurts to ask. Sometimes doctors will forget and we might need to remind them. That's what happened to me.

I would have thought the fact that you were very sick would be all the more reason to do bloods. When I have emergency admissions to hospital the first thing they do is stick needles in me. Blood tests don't prevent more invasive tests being done or treatments being given. There's no reason not to do them - either that or I have vampires posing as my doctors telling me more tests are needed so they can get more blood from me.

Currently I'm having bloods done once a month by my GP, mainly to measure my Vitamin D, but including a load of other things as well.

 

[Cross-stitch gal]

I think the reason my doctor didn't take any from me is because at the time he was going through all my records from a previous doctor. This one I began seeing in 2013 and the other I'd been seeing since 1996. However, I had records since I was born. So, he did a flexible sig on me and found everything he needed at the time until he was able to go through all those records.

Plus, in the records were quite a few blood tests from my previous doctor.

 

[Kero]

I had bloods done in like 2013 last, yes she has access to all my medical records. My GP ordered stools back in 2013 as well, but he was looking for bacteria and parasites, not a faecal calprotectin test. I see her again on June 11 so I guess I'll have more answers then. Thanks everyone

 

[Lady Organic]

is she still insiting you have IBS? Im not sure in what I am reading. if that is so I encourage greatly a second opinion.
there are more proactive GI out there. important data in IBD or suspicion of it have to be monitored from time to time, Vitamine B12, vit D, iron (anemia- especially you mention blood loss) etc... Inflammatory markers in blood can also fluctuate during a year when disease is active. taking no shot at it in one full year is not something I understand. this story doenst sound like an ideal monitoring to me.

 

[UnXmas]

I think the reason my doctor didn't take any from me is because at the time he was going through all my records from a previous doctor. This one I began seeing in 2013 and the other I'd been seeing since 1996. However, I had records since I was born. So, he did a flexible sig on me and found everything he needed at the time until he was able to go through all those records.

Plus, in the records were quite a few blood tests from my previous doctor.

That sounds very different to the approach taken by the (many) doctors I've seen. On another thread quite recently there was a discussion about how a new doctor always wants their own tests to be done (all tests, not just bloods), which is what I've always found to be the case. And blood results can change very quickly so new ones are needed to be of any use (with older ones only useful for comparison purposes). I don't know if your doctor's approach is less effective, but I do think it's unusual - or have many others here found doctors who don't want regular blood tests?

 

[Kero]

When I saw her last, before my colonoscopy, for my CT results, she was still insisting IBS that was April 29th. She has been insisting it since last year in July when she did her first scope, and found inflamation, but the biopsies showed negative for anything. And I didn't get those results until I saw her again in November. She said the inflamation was caused by my prep for the scope. She has me do the low FODMAP diet (which didn't change anything at all, still had pain, loose stool, etc). I saw her again Feb 2015 told her the diet didn't help so then she said we would do a CT scan. Had that done March 30, 2015. Results showed inflamation in about 10 cms of my terminal ileum. Saw her again April 29, and she said that we could treat the inflammation as a one time thing, and get it to go away or we could do another scope if I would like and take biopsies. So I naturally picked the scope cause I want to know what is causing the issues. I don't see my GI again until June 11. I found out about the positive colitis biopsy because my family doctor called me in to let me know. Mainly because he has been seeing me struggle for 2 years now.

I have seen my GI in office a total of 4 times. Everytime I talk to her I feel like she is judging me as just a hypochondriac. The last 3 times I have seen her and she orders a test, she says if it shows nothing then she is done seeing me.

 

[UnXmas]

So what diagnosis do you have currently?

 

[Axelfl3333]

It's usually automatic to get bloods done with crohns,almost anything I go to the doctor with usually ends with me getting blood tests,slightly strange not to.

 

[SupportiveMom]

No matter what your doc suspects, without blood work there is no baseline to understand what is happening. Some don't present many markers in blood work but tests still are needed. If you have active colitis in your terminal ileum I am baffled why a doc would do nothing. Maybe it is a GI not specializing in IBD?

If you don't get answers at your next appt in a few weeks I would ask questions like what her specialty is, does she have patients with IBD, and if they aren't to your liking find someone else. I'm disappointed a doc with inflammation in your small bowel would not have next steps discussed with that result.

 

[Kero]

So what diagnosis do you have currently?

My current diagnosis is active colitis in the terminal ileum, that is about all I know. Impatiently waiting to see the doc again in June

 

[24601]

Hi Kero,
I know it can be confusing with all the different ways people refer to inflammation in their bowel but I wanted to clarify to help you talk about what your tests show.

Colitis refers to inflammation of the colon. Ileitis is an inflammation of the ileum.

If your inflammation is in the terminal ileum then that's ileitis

Sorry you're still waiting for help. I really do think it sounds like you need a new doctor who will give you better care, including closer monitoring :ghug:

 

[Madhu]

Hi Kero,

My reply is probably too late Did you visit ur GI in June? What did she say? It sounds to me that you have to get another GI who is more concerned about diagnosis. I took my husband to a GI at first who diagnosed Crohn's immediately but took 3 months to do a pill cam test. I had no idea what Crohn's was at that time, so I never took it too seriously, until his symptoms started worsening. Once we were sent to a specialist GI for Crohn's, things went at rocket speed within a month. Its really about choosing the right GI which is the hardest thing.

I hope you feel better!