The Good Gut Guide: Help for IBS, Ulcerative Colitis, Crohn's Disease, Diverticulitis, Food Allergies and Other Gut Problems. Stephanie Zinser
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to know if you could have a specific illness? Think about any worries and anxieties that you might want addressed. Are you worried that you have the same cancer that your aunt died from? Talk to the doctor about your fears, no matter how silly they may suddenly seem in the cold light of day. Perhaps you want reassurance, or you might want some tests done – whatever it is, make sure you say, otherwise the consultation may end up being frustrating and unsatisfying. It helps the doctor if he knows what is on your mind and what you would like to happen.
Be Up-front
Sexuality nowadays occupies the foreground of most people’s lives, as well as the front pages of the popular media, and there is little shame in discussing sexual preferences and activities today. Anyone who indulges in anal intercourse, whether male or female, is at higher risk than normal of contracting anal and rectal infections, conditions or even injuries that may need medical treatment.
Don’t make your doctor guess. Say if you’ve been fooling about with sex toys, if you’re gay or if you engage in anal intercourse, or if your problem could be linked to (or affected by) your sex life. You’re much more likely to get the appropriate treatment – and quicker – if you don’t make your physician play detective.
Checklist for Doctor’s Visit
Use the following checklist to make an accurate list of your symptoms.
Constipation:
When was the last time you opened your bowels?
What are your stools like? Describe them.
Diarrhoea:
How many times a day is it happening?
How does this compare with your normal habit?
Do you get desperate urges to go to the loo and have you been incontinent?
Have you travelled abroad recently?
Bleeding:
Does it happen regularly and when did it start?
Does it happen when you open your bowels?
Do you have pain when you open your bowels?
Are there streaks of bright red blood on the toilet tissue, is it mixed in with your stools, or is it dark in colour?
Wind:
Are you passing excessive gas?
Do you feel bloated or ‘full’?
Do these feelings happen after meals?
Has your diet changed recently?
Pain:
Do you have abdominal or rectal pain?
How long have you had it?
Is it continuous, or does it only happen at specific times, for example when you try to pass a stool?
Itching:
Is it in one specific area of your body, for example your anal region?
Does it happen only at night, or is it more continuous?
Mucus:
Do you have mucus or any unusual or unpleasant-smelling discharge from your back passage?
Nausea and vomiting:
Do you feel or have you been sick?
Is it associated with certain times or activities, for example on waking in the morning or at mealtimes, or is it more constant?
Other questions:
Has your appetite changed recently?
Have you gained or lost weight unexpectedly?
Are you, or might you be, pregnant? When was the first day of your last period?
Do you feel unusually tired, lethargic, weak or dizzy?
Have you noticed anything else recently? For example, any hair loss that might be greater than normal or excessively dry skin?
Is it possible that sexual activities are playing even a minor role in your problem?
Investigating the Problems – a Look at Tests, Scans and ‘Scopes
There are many tests that may be done to pinpoint a specific bowel problem. Some of them are fine if you don’t mind needles; others are fine if you don’t mind a gloved finger fiddling about ‘down there’. Many of us mind it greatly! Some tests, like endoscopies, may involve a sedative, which helps if you’re nervous – although it does rather limit your ability to drive yourself home afterwards. Others – like ultrasound scans and some x-rays – are completely painless and simply involve you lying back and relaxing (supposedly). Here are the most common tests – how they are performed and their purposes …
Stool Tests
Stool specimens are asked for if the problem might be caused by infection – perhaps a bacterial infection like salmonella, or a parasitic infection like threadworms. If there are any bacteria or parasites, these will normally be present in the faeces.
Stool specimens may also show ‘occult’ bleeding – i.e. blood that cannot be visibly seen in the stools, but is present nonetheless. This may occur when there is bleeding higher up in the stomach or the upper reaches of the small intestine: by the time it is passed, it is no longer red, but dark brown or black and therefore may not be noticed.
Stool samples can also show increased amounts of mucus or pus, and will invariably show any blood that comes from the lower parts of the colon, rectum and anus.
Breath Tests
A simple analysis of the gas composition of exhaled breath is sometimes used to detect the presence of Helicobacter pylori in the stomach, or an overgrowth of bacteria in the small intestine.
Blood Tests
Blood is normally taken from a vein in the arm, using a fine needle with a syringe and a series of small vacuum tubes that ‘suck’ blood out automatically when they’re popped into the syringe housing. You’ll normally have a pressure cuff wrapped around your upper arm to increase the blood pressure and make collection easier, and you may also be asked to squeeze a small ball, or pump your hand into a fist. Apart from the slight scratch when the needle is put in, blood tests are not a problem for most people, but do tell the doctor or nurse if you are needle phobic, if you have one arm that gives blood more easily than the other, or if you have tricky veins.
The following list includes the various kinds of tests and the more common factors that doctors can study in blood, in order to understand what is going wrong.
