Doctor's In: The Patient Self-Treated but May Need More

 Q: Mary from New Jersey mentions left-sided lower abdominal pain and constipation that could be described as obstructive.  She self-treated herself and relieved her symptoms.  She wants to know if a further work up is necessary.

A:  This question brings up myriad concerns about work-ups; another reason why universal health coverage is important.  Bowel problems as
described could be simply constipation resolved with self-treatment or
something more ominous. Screening exams are the first line of defense for early detection of problems.  In the case of rectal or colon cancer, regular screenings can begin at age 50 with a colonoscopy or sigmoidoscopy. The fecal occult blood test is a simple one done in a doctor’s office or by the patient and can be life saving.

Signs and symptoms may also trigger a screening exam and workup, regardless of age.  Family history becomes important. Risk levels are high for more serious bowel problems when disease exists among family members.

In Mary’s case, the first step is to go to a general practitioner or family doctor to determine whether more extensive tests are necessary.  A complete gastro-intestinal work-up may be suggested.  Most of these tests will rule out conditions and that is what a patient wants to hear.  A danger lies in patients who self treat lingering problems without determining cause.

For example, colon cancers are lethal and in early stages, often painless. A simple
Fecal Occult Blood test may cast suspicion. As in all cancers, the earlier detected, the better the survival rate.

My advice to Mary would be to inform her regular doctor as to what she experienced and if more tests are indicated, he will recommend them.  

Dr. Marc Yacht retired as the Director of the Pasco County Health Department after twenty years of service to the community.  Have a question for Dr. Yacht? Email mjyacht58@gmail.com.