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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 25705
Experience:  Over 20 yrs of Family Practice
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How do i know if its a perforation

Customer Question

How do i know if its a perforation
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Chip replied 2 years ago.
How do you know?
Customer: replied 2 years ago.
Do i need to tell the dr to do an xray or act? My belly really hurts
Expert:  Dr. Chip replied 2 years ago.
I certainly would get at least the x-rays or better a ct with contrast, but again, I'd also do a proctoscope
Customer: replied 2 years ago.
Idk if i could allow someone to do a proctoscope. What can i do for my belly pain? Im waiting for them to call me back with my results
Expert:  Dr. Chip replied 2 years ago.
I can't tell you what to do for the pain until this gets checked out.
Customer: replied 2 years ago.
But i went to the dr like you said and got examined
Expert:  Dr. Chip replied 2 years ago.
And?
Customer: replied 2 years ago.
And what? They didnt say anything just did lab and sent me home
Expert:  Dr. Chip replied 2 years ago.
Yes but she didn't really rule out a perforation.
Customer: replied 2 years ago.
But she obviously isnt concerned about it. Shes just going to send me back to the GI dr. Im sure all my labs are normal otherwise they woulda called, right?
Expert:  Dr. Chip replied 2 years ago.
Here we go again with someone not seeming to be concerned. I don't think she should have stopped with just the digital and the blood work. It may be too soon for your white count to be elevated
Customer: replied 2 years ago.
Stop scaring me
Expert:  Dr. Chip replied 2 years ago.
What do you want me to do--say I was totally wrong and not to worry?
Customer: replied 2 years ago.
I want you to
Tell me the truth. But at the same time dont cause my anxiety over this to go crazy. Like you could tell me that its uncommon to get a perforation after forced anal sex. Do you think they woulda called me by now if my labs were abnormal
Expert:  Dr. Chip replied 2 years ago.
I already told you I wouldn't be worried if it weren't for the bleeding and the abdominal pain. I don't know what she might do with the blood work results.
Customer: replied 2 years ago.
Well what else coukd cause the pain and bleeding?
Expert:  Dr. Chip replied 2 years ago.
We've already discussed this. As for the bleeding, since it happened right after, you could have a rectal mucosal tear even if you don't have a perforation.
Customer: replied 2 years ago.
And will that heal by itself?
Expert:  Dr. Chip replied 2 years ago.
That would, yes But a rectal mucosal tear alone wouldn't cause severe abdominal pain
Customer: replied 2 years ago.
Sorry that i keep bringing this up
Expert:  Dr. Chip replied 2 years ago.
I know it worries you and it may not be a perforation but I'll feel much better when your GI can take a look at you
Customer: replied 2 years ago.
Ive gone to the bathroom since then and its been full of blood too
Expert:  Dr. Chip replied 2 years ago.
We really don't need to go on with this. That's why I wanted for you to have the proctoscope exam.
Customer: replied 2 years ago.
Sorry
Expert:  Dr. Chip replied 2 years ago.
That's OK--at least try to deal with it until you can see your GI
Customer: replied 2 years ago.
I had an appt to see the gi dr on the 29. Now its rescheduled for 9/12
Expert:  Dr. Chip replied 2 years ago.
But didn't you say he'd be back in on Thursday?
Customer: replied 2 years ago.
YA hell be back in office that day. Cant guarentee you hell see me. In case i havent mentioned this lately my belly really fricken hurts
Expert:  Dr. Chip replied 2 years ago.
I would certainly hope if you tell him all that's going on he'd see you right away. I don't have anything else to say about your pain other than suggest the ER
Customer: replied 2 years ago.
Will tylenol help? Heat?
Expert:  Dr. Chip replied 2 years ago.
You can try both
Customer: replied 2 years ago.
Colonoscopy and endoscopy tomorrow
Expert:  Dr. Chip replied 2 years ago.
Come again?
Customer: replied 2 years ago.
The np talked to my gi dr tomorrow. I have to have a coloniscopy and endoscopy tomorrow
Expert:  Dr. Chip replied 2 years ago.
Good, even though I doubt you're happy about that
Customer: replied 2 years ago.
Its not going to be my gi dr doing it its his partner. I am so crabby
Expert:  Dr. Chip replied 2 years ago.
I feel much better now
Customer: replied 2 years ago.
I dint
Customer: replied 2 years ago.
They didnt give me enough warninh
Expert:  Dr. Chip replied 2 years ago.
You'd only worry and fret over it if it were later so just hang in there.
Customer: replied 2 years ago.
I dont want it done. And i dont want it done by someone other than MY gi dr
Expert:  Dr. Chip replied 2 years ago.
Don't let that keep you from having it done. Have to be off for about six hours so don't post anything before then
Customer: replied 2 years ago.
Fine! And just so you know im mad
Expert:  Dr. Chip replied 2 years ago.
Sorry if you feel that way but since it's my birthday hopefully you can cut me a little slack and give me three more hours before you come back on
Customer: replied 2 years ago.
Im not mad at you. And happy birthday!!!Im not going to do it. Im going to just ignore the bleeding and the pain. I am scared.
Expert:  Dr. Chip replied 2 years ago.
I'm back
Customer: replied 2 years ago.
Happy birthdaypp
Expert:  Dr. Chip replied 2 years ago.
Thanks--on my own I'd never celebrate my birthday but I have some very insistent friends
Customer: replied 2 years ago.
You gotta celebrate sometimes. Im scared. Btw my calcium is low
Expert:  Dr. Chip replied 2 years ago.
How low?
Customer: replied 2 years ago.
.3 under normal
Expert:  Dr. Chip replied 2 years ago.
What's your vitamin D level?
Customer: replied 2 years ago.
My vitamin d level is 18 even though ive been on vit d 50,000 three times weekly for over 3 months.
Expert:  Dr. Chip replied 2 years ago.
Most likely that's the problem. Did the NP say anything about the low calcium?
Customer: replied 2 years ago.
She said to take a couple tums a couple times a day
Expert:  Dr. Chip replied 2 years ago.
Not really anything to worry about
Customer: replied 2 years ago.
I dont want to be scoped today by someone i dont know
Expert:  Dr. Chip replied 2 years ago.
You're repeating yourself
Customer: replied 2 years ago.
I know but im scared. Why cant it wait a day so my regular gi dr can do it
Expert:  Dr. Chip replied 2 years ago.
Would that happen? Can you schedule it like that?
Customer: replied 2 years ago.
It could be scheduled like that. But my gi dr was adament it had to happen today
Expert:  Dr. Chip replied 2 years ago.
I agree there's no time to lose but up to you. Get back to me in about three hours
Customer: replied 2 years ago.
Can i cancel it
Expert:  Dr. Chip replied 2 years ago.
You can do anything you choose to do but it really wouldn't make any sense
Customer: replied 2 years ago.
Honestly whats one more day
Expert:  Dr. Chip replied 2 years ago.
You haven't told me that you would be able to schedule it tomorrow as yet
Customer: replied 2 years ago.
I would be able to. But the gi said it has to be today. As far as i know my labs were All fine so why the rush
Expert:  Dr. Chip replied 2 years ago.
I assume you didn't ask him? I still think you needed at least the lower scope two days ago. But we're starting to chat and you're not really being logical and reasonable here
Customer: replied 2 years ago.
I didnt talk to him the NP did. How am i not being logical or reasonable? Ive had 5 scopes since january i dont want anymore
Expert:  Dr. Chip replied 2 years ago.
Come on--stop being silly. I've already told you that with rectal bleeding and severe abdominal pain after what happened I consider that an emergency. Now, please, let's change the subject
Customer: replied 2 years ago.
What did you do for your birthday
Expert:  Dr. Chip replied 2 years ago.
Just dinner with friends. I don't really "celebrate" birthdays
Customer: replied 2 years ago.
Youve said that before
Expert:  Dr. Chip replied 2 years ago.
Just another day for me
Customer: replied 2 years ago.
Did you atleast have some fun
Expert:  Dr. Chip replied 2 years ago.
Not really, no
Customer: replied 2 years ago.
Sorry. How come
Expert:  Dr. Chip replied 2 years ago.
I just don't do dinner and small talk well
Customer: replied 2 years ago.
Me either
Customer: replied 2 years ago.
Will you talk to me while they are startung the IV. I wish it was 1040 alreqady. Wha do you think of me going on a diet
Expert:  Dr. Chip replied 2 years ago.
Sorry--was off. I'll be here.
Customer: replied 2 years ago.
Do you primise me
Ill be ok
Expert:  Dr. Chip replied 2 years ago.
Yes--you'll be fine
Customer: replied 2 years ago.
What do you think of me going on a diet
Expert:  Dr. Chip replied 2 years ago.
What kind of diet?
Customer: replied 2 years ago.
A low calorie diet. Im guessing youll say no
Expert:  Dr. Chip replied 2 years ago.
If you don't go below around 1200 a day I'd be OK with it
Customer: replied 2 years ago.
Do you think my eating is ever going to get better?
Expert:  Dr. Chip replied 2 years ago.
With treatment, yes
Customer: replied 2 years ago.
Treatment? Like therapy?
Expert:  Dr. Chip replied 2 years ago.
Yes
Customer: replied 2 years ago.
Would you prefer i went to an inpatient treatment center
Expert:  Dr. Chip replied 2 years ago.
Yes, but I told you that before
Customer: replied 2 years ago.
For 2 weeks
Expert:  Dr. Chip replied 2 years ago.
At least
Customer: replied 2 years ago.
Im getting really nervous
Expert:  Dr. Chip replied 2 years ago.
I'm still here
Customer: replied 2 years ago.
I think im going to have a panic attack
Expert:  Dr. Chip replied 2 years ago.
Just calm down--you've been through this before
Customer: replied 2 years ago.
I cant calm down. Im scared. I knew this would happen. I am so pathetic
Expert:  Dr. Chip replied 2 years ago.
You'll be fine and stop with the terms like pathetic
Customer: replied 2 years ago.
The nurse isnt going to start the Iv shes going to have anesthesia do it
Expert:  Dr. Chip replied 2 years ago.
Sorry--had to be off again
Customer: replied 2 years ago.
2 pokes. Me and propofol dontnget along
Expert:  Dr. Chip replied 2 years ago.
So did you get the scopes?
Customer: replied 2 years ago.
Yes. I had a 7 mm ulcer in my prepylricmregion. Multie dispersed non bleedi g erosions found in gastric antrum. Diffuse mucosL flattening was found a 2nd part of
Duodenum. And a single 10 mm ulcer found in mid rectu
Expert:  Dr. Chip replied 2 years ago.
Did the GI talk about the ulcer in the rectum?
Customer: replied 2 years ago.
No
Expert:  Dr. Chip replied 2 years ago.
Did he say anything at all?
Customer: replied 2 years ago.
That hes testing me for celiac
Expert:  Dr. Chip replied 2 years ago.
Did he think the rectal ulcer was the cause for the bleeding?
Customer: replied 2 years ago.
He didnt say
Expert:  Dr. Chip replied 2 years ago.
I don't suppose the subject of Crohn's came up?
Customer: replied 2 years ago.
Nope it did not. It was just one ulcer
Expert:  Dr. Chip replied 2 years ago.
And how did he explain your belly pain?
Customer: replied 2 years ago.
He didnt. The nurses yelled at me and said i was "attention seeking"
Expert:  Dr. Chip replied 2 years ago.
Well, here's a thought--with the rectal ulcer and all the other and the elevated gastrin levels I'm thinking more and more of Crohn's
Customer: replied 2 years ago.
No ones even mentioned that but yoy. Its onlt one ulcer. I dont think nurses are suppose to yell at pt just cuz they dont wake up fast enough
Expert:  Dr. Chip replied 2 years ago.
What exactly happened?
Customer: replied 2 years ago.
They told me to
Open my eyes and i did but i didnt keep them open long wnough and then i cried and said i wanted to go home b. the nurse yelled at me and said i need to do what they say. When the anesthesiologist came over the nurse told him i was attention seeking. This is the same thing that happened last time i haf propofol.
Expert:  Dr. Chip replied 2 years ago.
Why didn't you keep your eyes open?
Customer: replied 2 years ago.
I thought they were. I was kinda outtA it still
Expert:  Dr. Chip replied 2 years ago.
Well, at least it's over with now
Customer: replied 2 years ago.
The nurse said i was attention seeking. Thatsxnot true!
Expert:  Dr. Chip replied 2 years ago.
If you were out of it still, how do you know exactly what the nurse did and said?
Customer: replied 2 years ago.
Cuz marty was back there with me and thats what he said. Do you think i have celiac
Expert:  Dr. Chip replied 2 years ago.
No--this really doesn't match celiac. And, remember, we can't really rely on Marty not to make things up.
Customer: replied 2 years ago.
Even the flattening of the duodenal mucosa.
Expert:  Dr. Chip replied 2 years ago.
Even with that, celiac wouldn't cover the ulcers and the bleeding
Customer: replied 2 years ago.
So what the heck is going on with me
Expert:  Dr. Chip replied 2 years ago.
I still then it's Crohn's
Customer: replied 2 years ago.
I dobt have to have a repeat scope to make sure its healeddo i
Expert:  Dr. Chip replied 2 years ago.
Can't say for sure--you need to ask the GI about that
Customer: replied 2 years ago.
Would you make me have a repeat one? My abdomen hurts more now than earlier
Expert:  Dr. Chip replied 2 years ago.
If you continued to bleed, yes
Customer: replied 2 years ago.
Why does my stomach hurt
Expert:  Dr. Chip replied 2 years ago.
I don't know for sure
Customer: replied 2 years ago.
Is it from the colonoscopy/endoscopy? Do we need to close this page. I was suppose to see my therapist this am but didnt. Do you think i should call him wiith my drinking issue
Customer: replied 2 years ago.
http://s1280.photobucket.com/user/Kate_Miller2007/media/image_zps2444061d.jpg.html
Expert:  Dr. Chip replied 2 years ago.
That's the prepyloric ulcer?
Customer: replied 2 years ago.
Its the one in my rectum
Expert:  Dr. Chip replied 2 years ago.
OK--looks fairly shallow which is good. We do need to close the page and, yes, your therapist should be told about the drinking
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 25705
Experience: Over 20 yrs of Family Practice
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