The Diagnosis Journey Part II: Gastrointestinal Specialist
In the first part of this series, I documented my experience with my primary care doctor who suspected my new abdominal pain was an ulcer. He referred to a Gastroenterologist, commonly referred to as a “GI doctor.”
The GI doctor spent about half an hour with me discussing my overall symptoms. I told him how my medication had been changed over the past four years including that while I felt the best on Prevacid, I had weaned down to Zantac (H2 blocker) and then switched to Pepcid due to my concerns about bone loss. You may recall that my primary care doctor gave me samples of Dexilant, a proton pump inhibitor, I reported that I was feeling better though I still had a “lump” feeling in my chest.
I expected the GI specialist to want to do an endoscopy; however, he instead said that he wasn’t sure it was needed. He asked me about symptoms that may suggest Eosinophilic Esophagitis (EoE). He then said that if I did indeed have an ulcer it was likely to be mostly healed if not healed by the time I was able to get an endoscopy scheduled. He said the only reasons he can see to do an endoscopy is to monitor for the presence of Barrett’s esophagus (a precancerous condition) which he didn’t feel I fit the profile for or to rule out EoE. This discussion was ended with let’s wait and see how I do on the new medication and if I do not continue to feel better, then I could call and schedule an endoscopy.
I left with a one month prescription for generic Prevacid (lansoprazole) with one refill. I need to call back if it helps and he will write me a prescription for a 90 day mail order prescription. If it doesn’t help, I need to call back and I suspect he will suggest either another prescription or going forward with the endoscopy.
Overall, this visit was a very positive visit. I appreciated that the doctor spent time with me and listened to what I had done. He seemed comfortable with my level of knowledge both about my body and about reflux. He treated me as an equal partner in the decisions about how to treat my reflux symptoms. I appreciated his problem solving with me and discussing benefits and risks medicating with PPIs vs. bone loss risk as well as the pros and cons of endoscopy.
While I expected this to be a three part series with the third part being my endoscopy, I am pleasantly surprised to report that for now, there’s one less appointment on my horizon!