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New here. Gastroenterologist insisted on hysterectomy?

I am currently at an impasse with a gastroenterologist. Actually, it was a while ago, but I have yet to find a way around it. I guess what I need to know is how a gastroenterologist can and cannot help me control my condition. I have had issues with fecal incontinence and diarrhea for over five years now, and it has mostly just gotten worse with the addition now of abdominal pain and spasms.

I hope I can be rational and not reactive while writing this. I am trying to be concise, but there is just a lot of implied communication. I have no family or friends to discuss this situation with.

At my last appointment, The gastroenterologist said he would not order any imaging until I had a hysterectomy. [Some details at end.] He did recommend a colonoscopy, which I cancelled because I thought my household was likely to have out of town visitors sharing my bathroom. I would now prefer a different gastroenterologist because of his focus on a hysterectomy which is not his specialty.

I did see my current gynecologist for a surgical consult. She said there was no need for a hysterectomy but it was entirely my choice. She ordered an ultrasound to see the current status of my fibroid (about 17 centimeters when it was imaged years ago. The size of the fibroid could not be measured based on the ultrasound.

My gynecologist did place a referral to a nutritionist, whose advice did help a lot, but I am currently having a really bad flare of diarrhea and incontinence.

I also saw a Physical Therapist for pelvic floor therapy for my urinary incontinence. Her advice was to work with the nutritionist to control my stool texture through diet. This helped a lot, until it didn't.

I told my gynecologist that I really wanted to see a different gastroenterologist. She said it would be highly unusual for her to refer me to someone outside the practice. My interpretation is that she thinks that another GI person in the practice would not disagree with the previous person. ( I infer this because I did not specify that I wanted to go outside the practice.) She mentioned that I might go see someone in a major city several hours away by a car (which I don't own.). She was very diplomatic about the difference on opinion on my hysterectomy. She said that while hysterectomies are very common, MINE would be a major surgery and require a 8 week recovery period due to the large size of the fibroid.

For what it's worth, I finally ordered my medical records. The gastroenterologist wrote nothing about his refusal to order imaging.

I did go back to my primary doctor (at a different clinic) and request a referral from a different practice ( if there is one locally.) But the referral department at my primary care clinic is a bureaucratic nightmare. I am having all kinds of issues with my cell phone not working where I live.

I an 64 years old and I am overdue for a routine colon cancer screening. I did have a sigmoidoscopy by this gastroenterologist perhaps 5 years ago, and he found no issues.

I did discuss this with my primary doctor. He gave me a kit for sending in a stool sample for colon cancer screening, but it has been impossible for me to coordinate taking a stool sample. ( and fecal urgency and diarrhea makes getting a stool sample an issue.)

So many more factors are involved in this! I experience a lot of anxiety over my living situation. ( I have been told I can't live here if I have accidents, but I cannot afford to move either.)

Regarding my previous gynecologist, I found several untruths in my medical records regarding my fibroid symptoms, our discussion of potential surgical complications and my consent to an oophorectomy (ovary removal). My decision to schedule a hysterectomy was based solely on my belief that it could help with my urinary incontinence and a urologist wanting to do a procedure which would prevent future MRIs to monitor the fibroid. My household was insisting that I did not understand my doctors' advice and I should just go along with it.

I have a LOT of general vague symptoms that really are just accumulating and nothing gets resolved. My symptoms are vague and intermittent. I never sleep more than four hours. I have mild psoriasis. I am obese. I have knee pain. I am very unsatisfied with my living situation but do not have the energy to really resolve much. The isolation from the pandemic has only made everything worse.

  1. I'm so sorry that you're dealing with so many things. I'm not a doctor and I don't know much about the conditions you're describing, however I generally don't like when doctors try to pressure me into something that doesn't feel right. After all, it should be the doctor's job to give you all the information and different treatment options and explain the results you could expect with each one, but the final decision should be up to you. If you're not comfortable with your doctor's advice, I would get a second or third opinion, but getting surgery that might or might not be necessary because people are pressuring you to do it doesn't sound right. However, again, I'm not a doctor and have no medical knowledge about this whatsoever. I'm just saying this because when reading your comment, I'm getting the impression that you don't want to get a hysterectomy. If your household is insisting that you don't understand the doctor's advice, I would probably suggest scheduling another appointment so they can explain it better. This way you can make an informed decision. Maybe this article could also be helpful: Wishing you all the best, Karina (team member)

    1. Thanks for the article! It would be good to know the outcome of the author's surgery. I wish they had posted a follow up.

      I have some good news! I mentioned my dilemma at a support group. One of the other participants recommended I try her gastroenterologist. This will give me someone local but outside the practice of the previous gastroenterologist. I will need to confirm that they will accept my insurance, but I have hope.

      Also, I have quit drinking coffee which has helped greatly with my diarrhea and fecal incontinence. Strangely, I am having a lot of GERD and burping lately. I still have a lot of urgency and need to rush to the bathroom, but no messy accidents.

      I am now hopeful that I can juggle my diet and minimize my stress to decrease my symptoms to a tolerable level.

      1. That's great news! I hope that everything will work out with the insurance and that you'll be able to see gastroenterologist soon. Will you keep us updated about that?

        As for the diet changes, that must be such a relief, too! I also find that sometimes little changes like this can make a huge difference.
        How is your diet looking at the moment? Have you find any ways to minimize stress that work for you?
        Karina (team member)

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