Gastroenterology 101

Digestive system

I just returned from an early morning appointment with my fifth local gastroenterologist. The reason I keep looking for one is that I have had a flare-up of digestive problems since summer.  You may recall that I had parasites, about which I wrote in 2007. Dr. Dietrich Klinghardt in Seattle prescribed a  combination of antibiotics and herbal preparations which killed those critters then. My present symptoms are similar, and showed up following a colonoscopy.

I travelled to Seattle in ’07 because I could not find a gastroenterologist in Pittsburgh who would consider parasites as apossibility.  After the last one told me without cracking a smile that “food has nothing to do with digestion,” I swore I would NEVER go to another.  Hoping not to have to return to Seattle, I gave Pittsburgh’s doctors one more try.

This one looked  different:  a female with a certification in nutrition!  My hopes that she would know something about diet were shattered however, when, after completing my colonoscopy this summer she handed me a prescription for colitis, while I was still under the cloud of anesthetic. In response to my question about foods, she declared that there was “no known diet” for that condition.  I tossed her prescription, after reading the long list of side effects online.  Still, I harbored the false hope that I might have a conversation with her about my chronic condition. Hence the appointment this morning, for which I rose at the ungodly hour of 5:30 am and drove in the dark to be there at 7:00 am.

The night before I had dutifully and carefully completed an 8-page questionnaire, with queries about my family history of illness, my present medications (only a bit of thyroid), and supplements (a lengthy list of herbs and vitamins which required an additional page.) The paperwork contained not a single question about diet.  Since I was instructed to bring my history with me, I doubted seriously whether
anyone would read it before my appointment. I was correct.

First, an obese nurse weighed me and took my “vitals.” (Is it my imagination or are most nurses unhealthy looking and overweight?) She registered surprise at my low blood pressure. “How old are you?” she asked.  “It’s in my paperwork,” I replied petulantly.  Next, I was moved to a tiny room with a single chair and a lone magazine, “Colitis Today.”  The door closed. I decided to flip through the magazine while waiting. Articles about dealing with the psychological effects of the disease, and ads for clothing that allowed quick and easy toileting. I slammed it shut.  Was I in denial?

Thank goodness I brought a book.  After 15 minutes, another over-weight nurse came rushing in (two for two!),  apologizing.  “Oh, you’re in the wrong room! Follow me.”  We wentacross the hall to an identical cubicle. The reading material in this room was a sports magazine with Raphael Nadal on the cover. Obviously, this was the right room, since I am a tennis fan!   I waited some more.  After another   15 minutes (it’s now 8 am.  I could have slept another hour! How can adoctor be running an hour late first thing in the morning?) A rap on the door, and  the doctor appears with my paperwork in hand.

I had scripted a brief description of my life’s work with families of children with disabilities and my belief that diet and nutrition were worthwhile treatment options.   Before I opened my mouth, however, the good doctor began questioning.  “Any history of colon cancer in your family?” “Yes, both my parents had color cancer. That’s why I came to you for a colonoscopy this summer. It’s in my  paperwork,” I stated for the second time that morning.  She flipped the pages.  “Oh, now I remember you,” she declared.

She continued asking me questions, this time about alcohol and caffeine consumption, again documented in the unread paperwork. I offered up that I ate well, a mostly organic, almost vegetarian diet. “Maybe that’s your problem,” she replied. (Does she subscribe to the hygiene hypothesis, I wondered silently.) Patience, which is not one of my virtues, was running out.

Finally, I interrupted her with my prepared  script, which I had edited and tweaked several times in my mind to be sure to sound respectful.  I ended by stating my surprise that her questionnaire contained no queries about diet.  “Oh, this is a terrible form, she admitted.  We really need to revise it!”

She politely explained my condition as one of “inflammation of unknown origin.” I politely inquired if she was not curious about possible origins. We were both holding our tempers well.  She forthrightly stated that studies were “inconsistent.”  “Could that be because people are all different?” I asked naively.
“Maybe,” she said.  “But drugs are the only way to treat your condition. And I have no problem with your getting some acupuncture and chiropractic too.”  Wow! She just embraced complementary medicine!

“Is it possible that I have an infection?” I asked.  “If you would like me to order some stool studies, I would be happy to do so,” she replied. “But you would not have ordered them if I had not asked?”  “No,” she answered, unfazed.

I have had a number of stool studies, which are notoriously unreliable.  Critters often don’t show up, which does not mean that they are not there.  When I shared my knowledge on this subject, my doctor said, “That’s why I don’t order them!”

I persisted. “How about possible food allergies?”  “Well, I would be happy to refer you to an allergist, if you’d like; I don’t do allergy testing.  (No multi-disciplinary approach that considers the whole person here.)  I used to do elimination diets, but they don’t work, so I don’t recommend them anymore.”  “Don’t  work?” I asked why?  “Because no one can stick with them,” she stated. Determined to win one argument for food, I continued,   “Oh, you mean they might workphysically, but not psychologically?”  “That is correct,” she agreed. One point for me!

“Are you going to examine me,” I asked staring atthe cold, hard, stainless steel table next to me. “Of course,” she declared. I hopped up onto the examining table which could have been in a museum of torture devices, and lay back.  No removal of clothing.  Afterpalpating my abdomen, she declared “All done!” and I sat up.

This seemed to be a good time to escape. I thanked her and headed toward the door.  As I was exiting, she asked me an astonishing question, “Does changing their diet help children with autism?”  “Yes,
I replied, elated that I could share some of my knowledge.  80% show benefit from a gluten- and casein-free diet. Not only do their bowels work better, but often we see positive changes in their language output and relatedness.”  “That’s SO interesting!” was her response.

I ran to the elevator.  Past the tables of Pepto-Bismal-pink raffle items (including an iridescent pink pumpkin!) for breast cancer awareness month. (Excuse me.  Do you know ANYONE who is NOT aware yet?) I couldn’t get out of this hospital, in which I was born more than 65 years ago,
fast enough.

Today’s doctor WAS different. Traditional, yes, but not bad, just uneducated. Thank goodness, she still has an inbox and a smidgen of curiosity. I do not want to be her teacher. I will return to my trusted and
educated team of health care professionals: a chiropractic kinesiologist,acupuncturist, herbalist, and homeopath.  We were making slow, but steady progress toward improving my health. I will continue my regemin of vitamins, minerals, anti-fungals, herbs and remedies, as well as my organic diet, while I work on my patience. This time I will not throw away her prescription.  I will keep it just in case I change my mind, and decide that hair loss and a possible stroke are worth exchanging for some bowel issues. I will then return to her for another round.

Until then, I will continue my stubborn search for the cause of my inflammation and treat it naturally. Tomorrow I will start drinking 32 ounces of apple cider and eating a totally vegan diet for six days in
preparation for a gall bladder and liver cleanse this weekend.  I’m encouraged by what I read about it.  In the meantime, if you EVER hear me consider going to another gastroenterologist, please slap me upside my face!  Thanks.

I’ll keep you posted.

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One Response to “Gastroenterology 101”

  1. oliviadiamond Says:

    I liked your short-course on gastroenterology. I’ve often wondered why anyone would take the drugs advertised on television after hearing the list of side effects. Laughter is good medicine and a had a dose of it in this essay.

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