Your doctor is one of the most important paths to good health
But you need to know what to talk about
Often patients go to their doctor but they do not have a clear understanding of what is important to talk about.
This section is about arming you with the discussion topics that are important if you have inflammatory bowel disease.
Your symptoms:
You should be able to tell your doctor if you have the following symptoms, how often you have them and what triggers them to start or get worse and what makes them better.
For example: "I am having diarrhea 5 times a day, usually after meals that are fatty. Loperamide decreases it."
The following are important symptoms to mention:
Remember that feeling OK is not good enough. We want you to feel well so you need to tell your doctor all the important symptoms.
Your medications:
It is important to always come with a list of all the medications you take including ones over the counter. You should understand why you are taking these medications and be familiar with possible side effects.
If you have been previously treated for IBD, try to keep a record of what medications you tried in the past. It helps a lot if you can recall when and for how long you took them and why you stopped e.g. allergy, side effect, ineffective.
How will your doctor monitor you?
Symptoms unfortunately do not always tell the whole story and may not help in predicting early a relapse. This is why your doctor may need to do some tests to understand the level and extent of your disease.
These are initial tests that should be considered:
For more in depth assessment other tests such as radiology imaging (CT or MR enterography) and a colonoscopy may be ordered.
This section is about arming you with the discussion topics that are important if you have inflammatory bowel disease.
Your symptoms:
You should be able to tell your doctor if you have the following symptoms, how often you have them and what triggers them to start or get worse and what makes them better.
For example: "I am having diarrhea 5 times a day, usually after meals that are fatty. Loperamide decreases it."
The following are important symptoms to mention:
- abdominal pain or cramps
- bowel movement changes (diarrhea or constipation)
- bloating and abdominal distension
- nausea and/or vomiting
- weight loss
- poor appetite
- fever
- passage of blood
- skin or joint changes
- fatigue or poor exercise tolerance
- any disease around your anus
Remember that feeling OK is not good enough. We want you to feel well so you need to tell your doctor all the important symptoms.
Your medications:
It is important to always come with a list of all the medications you take including ones over the counter. You should understand why you are taking these medications and be familiar with possible side effects.
If you have been previously treated for IBD, try to keep a record of what medications you tried in the past. It helps a lot if you can recall when and for how long you took them and why you stopped e.g. allergy, side effect, ineffective.
How will your doctor monitor you?
Symptoms unfortunately do not always tell the whole story and may not help in predicting early a relapse. This is why your doctor may need to do some tests to understand the level and extent of your disease.
These are initial tests that should be considered:
- complete blood count (CBC). This checks if your hemoglobin to see if you are anemic.
- Electrolytes (sodium, potassium, calcium, magnesium). These can be abnormal from diarrhea or malabsorption.
- Urea and creatinine. These tests for kidney function and sign of dehydration.
- Liver profile. Helps to rule out any underlying liver disease that can be associated with IBD or may alter with medication selection.
- Ferritin and vitamin B12 level to assess for deficiencies
- C-reactive protein (CRP). This is a marker of inflammation.
- a stool test called fecal calprotectin. This is a marker for intestinal inflammation
For more in depth assessment other tests such as radiology imaging (CT or MR enterography) and a colonoscopy may be ordered.
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Although not necessary at first visit, I will often order some tests early as I may need these results available later before certain medications or treatments can be prescribed.
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Tell us as much as you can
You may not feel comfortable on a first visit but these are also crucial to mention since they are important in your well being.
- sexual difficulties from poor sexual drive or vaginal pain. This information can change treatment or investigation choices.
- work or school problems. We need to know how the disease is affecting your life so we can help you.
- Family planning. Treatment plans will need to be discussed with you and your partner if you are planning to have a baby in the following 6-12 months.
Be honest about smoking
We all know smoking is not good for us for many reasons but you may not appreciate that smoking has clearly been shown to worsen Crohn's disease and is a factor in more difficult to treat disease.
So tell us and we can try to help you.
So tell us and we can try to help you.
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VaccinesAlthough strong evidence is not yet available, I believe vaccination is important especially as many of our patients will be on immune suppressing agents.
I will typically consider vaccination for:
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