A common lament I hear from my patients as they try to discuss a real concern they have about their body: “I’m sorry; this is so disgusting!” Their cheeks burn with shame as they tell me how their bowels have betrayed them. No matter what the issue is, so many of my patients are mortified discussing their diarrhea, constipation, fecal incontinence. My response, always, is “you can’t gross me out – we talk about poop every day in this clinic!”
Plenty of things can go wrong in the gastrointestinal tract, and even minor issues can be really disruptive in a person’s life. Certain features of bowel dysfunction, like blood in the stool, abdominal pain, and weight loss, might signal more urgency to get a problem diagnosed and fixed. We certainly don’t want to miss things like tumors, ulcers, inflammatory bowel disease, and diseases that might affect absorption of nutrients.
Oftentimes, none of those “red flags” are present, but a patient’s gastrointestinal symptoms are affecting their ability to function at work or socially. In cases when we either have ruled out or have low suspicion for something “bad” we can still offer plenty to help with these symptoms. Sometimes that might mean trials of elimination of food types, dietary changes, addition of fiber, or other medications. GI symptoms might be a side effect of another medication. We frequently have to do some trial and error to find the right combination of things that improve an individual’s function, but usually we can do so. In some cases consulting with gut specialists, dietitians, even physical therapists, can be very helpful.
My point here is this: if you are having gut symptoms that are worrying you or disrupting your day-to-day life, let’s talk about it! Whatever discomfort you have discussing it, I promise, is not shared by your primary care provider or friendly gastroenterologist. We want to help you get answers. And even if there is not a simple diagnosis or fix to the problem, we want to help you be more comfortable leaving the house without worrying about what your gut will do. So please, don’t let feeling grossed out keep you from asking the question.
Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc. For free and easy access to the entire Prairie Doc library, visit www.prairiedoc.organd follow Prairie Doc on Facebook. Andrew Ellsworth, M.D. is part of The Prairie Doc team of physicians and currently practices family medicine in Brookings, S.D. Kelly Evans-Hullinger, M.D. is part of The Prairie Doc® team of physicians and currently practices internal medicine in Brookings, South Dakota.
