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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22258
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: 11 months ago.
Category: Health
Expert:  Dr. Chip replied 11 months ago.
How do you know?
Customer: replied 11 months ago.
Do i need to tell the dr to do an xray or act? My belly really hurts
Expert:  Dr. Chip replied 11 months 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 11 months 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 11 months ago.
I can't tell you what to do for the pain until this gets checked out.
Customer: replied 11 months ago.
But i went to the dr like you said and got examined
Expert:  Dr. Chip replied 11 months ago.
And?
Customer: replied 11 months ago.
And what? They didnt say anything just did lab and sent me home
Expert:  Dr. Chip replied 11 months ago.
Yes but she didn't really rule out a perforation.
Customer: replied 11 months 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 11 months 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 11 months ago.
Stop scaring me
Expert:  Dr. Chip replied 11 months ago.
What do you want me to do--say I was totally wrong and not to worry?
Customer: replied 11 months 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 11 months 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 11 months ago.
Well what else coukd cause the pain and bleeding?
Expert:  Dr. Chip replied 11 months 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 11 months ago.
And will that heal by itself?
Expert:  Dr. Chip replied 11 months ago.
That would, yes But a rectal mucosal tear alone wouldn't cause severe abdominal pain
Customer: replied 11 months ago.
Sorry that i keep bringing this up
Expert:  Dr. Chip replied 11 months 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 11 months ago.
Ive gone to the bathroom since then and its been full of blood too
Expert:  Dr. Chip replied 11 months 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 11 months ago.
Sorry
Expert:  Dr. Chip replied 11 months ago.
That's OK--at least try to deal with it until you can see your GI
Customer: replied 11 months ago.
I had an appt to see the gi dr on the 29. Now its rescheduled for 9/12
Expert:  Dr. Chip replied 11 months ago.
But didn't you say he'd be back in on Thursday?
Customer: replied 11 months 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 11 months 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 11 months ago.
Will tylenol help? Heat?
Expert:  Dr. Chip replied 11 months ago.
You can try both
Customer: replied 11 months ago.
Colonoscopy and endoscopy tomorrow
Expert:  Dr. Chip replied 11 months ago.
Come again?
Customer: replied 11 months ago.
The np talked to my gi dr tomorrow. I have to have a coloniscopy and endoscopy tomorrow
Expert:  Dr. Chip replied 11 months ago.
Good, even though I doubt you're happy about that
Customer: replied 11 months ago.
Its not going to be my gi dr doing it its his partner. I am so crabby
Expert:  Dr. Chip replied 11 months ago.
I feel much better now
Customer: replied 11 months ago.
I dint
Customer: replied 11 months ago.
They didnt give me enough warninh
Expert:  Dr. Chip replied 11 months ago.
You'd only worry and fret over it if it were later so just hang in there.
Customer: replied 11 months ago.
I dont want it done. And i dont want it done by someone other than MY gi dr
Expert:  Dr. Chip replied 11 months 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 11 months ago.
Fine! And just so you know im mad
Expert:  Dr. Chip replied 11 months 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 11 months 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 11 months ago.
I'm back
Customer: replied 11 months ago.
Happy birthdaypp
Expert:  Dr. Chip replied 11 months ago.
Thanks--on my own I'd never celebrate my birthday but I have some very insistent friends
Customer: replied 11 months ago.
You gotta celebrate sometimes. Im scared. Btw my calcium is low
Expert:  Dr. Chip replied 11 months ago.
How low?
Customer: replied 11 months ago.
.3 under normal
Expert:  Dr. Chip replied 11 months ago.
What's your vitamin D level?
Customer: replied 11 months 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 11 months ago.
Most likely that's the problem. Did the NP say anything about the low calcium?
Customer: replied 11 months ago.
She said to take a couple tums a couple times a day
Expert:  Dr. Chip replied 11 months ago.
Not really anything to worry about
Customer: replied 11 months ago.
I dont want to be scoped today by someone i dont know
Expert:  Dr. Chip replied 11 months ago.
You're repeating yourself
Customer: replied 11 months ago.
I know but im scared. Why cant it wait a day so my regular gi dr can do it
Expert:  Dr. Chip replied 11 months ago.
Would that happen? Can you schedule it like that?
Customer: replied 11 months ago.
It could be scheduled like that. But my gi dr was adament it had to happen today
Expert:  Dr. Chip replied 11 months ago.
I agree there's no time to lose but up to you. Get back to me in about three hours
Customer: replied 11 months ago.
Can i cancel it
Expert:  Dr. Chip replied 11 months ago.
You can do anything you choose to do but it really wouldn't make any sense
Customer: replied 11 months ago.
Honestly whats one more day
Expert:  Dr. Chip replied 11 months ago.
You haven't told me that you would be able to schedule it tomorrow as yet
Customer: replied 11 months 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 11 months 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 11 months 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 11 months 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 11 months ago.
What did you do for your birthday
Expert:  Dr. Chip replied 11 months ago.
Just dinner with friends. I don't really "celebrate" birthdays
Customer: replied 11 months ago.
Youve said that before
Expert:  Dr. Chip replied 11 months ago.
Just another day for me
Customer: replied 11 months ago.
Did you atleast have some fun
Expert:  Dr. Chip replied 11 months ago.
Not really, no
Customer: replied 11 months ago.
Sorry. How come
Expert:  Dr. Chip replied 11 months ago.
I just don't do dinner and small talk well
Customer: replied 11 months ago.
Me either
Customer: replied 11 months 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 11 months ago.
Sorry--was off. I'll be here.
Customer: replied 11 months ago.
Do you primise me
Ill be ok
Expert:  Dr. Chip replied 11 months ago.
Yes--you'll be fine
Customer: replied 11 months ago.
What do you think of me going on a diet
Expert:  Dr. Chip replied 11 months ago.
What kind of diet?
Customer: replied 11 months ago.
A low calorie diet. Im guessing youll say no
Expert:  Dr. Chip replied 11 months ago.
If you don't go below around 1200 a day I'd be OK with it
Customer: replied 11 months ago.
Do you think my eating is ever going to get better?
Expert:  Dr. Chip replied 11 months ago.
With treatment, yes
Customer: replied 11 months ago.
Treatment? Like therapy?
Expert:  Dr. Chip replied 11 months ago.
Yes
Customer: replied 11 months ago.
Would you prefer i went to an inpatient treatment center
Expert:  Dr. Chip replied 11 months ago.
Yes, but I told you that before
Customer: replied 11 months ago.
For 2 weeks
Expert:  Dr. Chip replied 11 months ago.
At least
Customer: replied 11 months ago.
Im getting really nervous
Expert:  Dr. Chip replied 11 months ago.
I'm still here
Customer: replied 11 months ago.
I think im going to have a panic attack
Expert:  Dr. Chip replied 11 months ago.
Just calm down--you've been through this before
Customer: replied 11 months ago.
I cant calm down. Im scared. I knew this would happen. I am so pathetic
Expert:  Dr. Chip replied 11 months ago.
You'll be fine and stop with the terms like pathetic
Customer: replied 11 months ago.
The nurse isnt going to start the Iv shes going to have anesthesia do it
Expert:  Dr. Chip replied 11 months ago.
Sorry--had to be off again
Customer: replied 11 months ago.
2 pokes. Me and propofol dontnget along
Expert:  Dr. Chip replied 11 months ago.
So did you get the scopes?
Customer: replied 11 months 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 11 months ago.
Did the GI talk about the ulcer in the rectum?
Customer: replied 11 months ago.
No
Expert:  Dr. Chip replied 11 months ago.
Did he say anything at all?
Customer: replied 11 months ago.
That hes testing me for celiac
Expert:  Dr. Chip replied 11 months ago.
Did he think the rectal ulcer was the cause for the bleeding?
Customer: replied 11 months ago.
He didnt say
Expert:  Dr. Chip replied 11 months ago.
I don't suppose the subject of Crohn's came up?
Customer: replied 11 months ago.
Nope it did not. It was just one ulcer
Expert:  Dr. Chip replied 11 months ago.
And how did he explain your belly pain?
Customer: replied 11 months ago.
He didnt. The nurses yelled at me and said i was "attention seeking"
Expert:  Dr. Chip replied 11 months 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 11 months 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 11 months ago.
What exactly happened?
Customer: replied 11 months 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 11 months ago.
Why didn't you keep your eyes open?
Customer: replied 11 months ago.
I thought they were. I was kinda outtA it still
Expert:  Dr. Chip replied 11 months ago.
Well, at least it's over with now
Customer: replied 11 months ago.
The nurse said i was attention seeking. Thatsxnot true!
Expert:  Dr. Chip replied 11 months ago.
If you were out of it still, how do you know exactly what the nurse did and said?
Customer: replied 11 months ago.
Cuz marty was back there with me and thats what he said. Do you think i have celiac
Expert:  Dr. Chip replied 11 months ago.
No--this really doesn't match celiac. And, remember, we can't really rely on Marty not to make things up.
Customer: replied 11 months ago.
Even the flattening of the duodenal mucosa.
Expert:  Dr. Chip replied 11 months ago.
Even with that, celiac wouldn't cover the ulcers and the bleeding
Customer: replied 11 months ago.
So what the heck is going on with me
Expert:  Dr. Chip replied 11 months ago.
I still then it's Crohn's
Customer: replied 11 months ago.
I dobt have to have a repeat scope to make sure its healeddo i
Expert:  Dr. Chip replied 11 months ago.
Can't say for sure--you need to ask the GI about that
Customer: replied 11 months ago.
Would you make me have a repeat one? My abdomen hurts more now than earlier
Expert:  Dr. Chip replied 11 months ago.
If you continued to bleed, yes
Customer: replied 11 months ago.
Why does my stomach hurt
Expert:  Dr. Chip replied 11 months ago.
I don't know for sure
Customer: replied 11 months 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 11 months ago.
http://s1280.photobucket.com/user/Kate_Miller2007/media/image_zps2444061d.jpg.html
Expert:  Dr. Chip replied 11 months ago.
That's the prepyloric ulcer?
Customer: replied 11 months ago.
Its the one in my rectum
Expert:  Dr. Chip replied 11 months 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: 22258
Experience: Over 20 yrs of Family Practice
Dr. Chip and 2 other Health Specialists are ready to help you

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