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Ask Internist Your Own Question
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 4766
Experience:  Int. Med., Gastroenterology. Fellow American College of Physicians. Trained, located in the U.S.
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Where in the United States are our best diagnosticians We

Customer Question

Where in the United States are our best diagnosticians? We have tried Cleveland Clinic, U of Miami, Mayo Clinic, Shands Medical Center (all in Florida) and numerous local physicians. Is there a GI speciality hospital somewhere in the United States? We are desparate.
Submitted: 8 years ago.
Category: Medical
Expert:  Internist replied 8 years ago.

What disease or symptoms do you have?
Customer: replied 8 years ago.

*severe left sided abdominal pain

*constant nausea

*occasional vomiting

*excessive weight gain ( 100 lbs)

*symptoms began (7 years ago) with bloating, gas and occasional diarrhea slowly over

time symptoms increased to constant daily diarrhea (sometimes 12 times a day).

Sometimes would sleep on the bathroom floor at night to be sure he did not have

an accident.

* treated initially with many irritable bowel syndrome meds which did nothing to stop

the diarrhea. At its peak he was taking 6 imodium a day and it was not controlling it.

*when symptoms were at their worse, whenever he ate, usually within 5 minutes, he

develop get diarrhea. At that time all dairy and most foods made him sick.

* January 2009 symptoms changed now to severe constipation, causing hard stools

and bleeding. Now having 4 to 5 bowel movements a week. This is likely a result

of the narcotics he is taking for the pain. This has allowed him to add to his diet.

But it all likelihood if the pain and depression meds were withdrawn, his diarrhea

will begin again.

* the pain never goes away,he is sick every day. Gets out of the house only for medical

appointments. Usually having to reschedule appointments at least three times before

he can manage to make it to appointment.

*he is always hot. We have to keep the house and car when he travels so cold that

other family members are uncomfortable. They have to wear sweaters and jackets

but he is still hot

*he cannot bend down any longer due to pain. He constantly shifts his position when

sitting down trying to get comfortable. He walks with a cane because it helps. He is

28 years old. He sleeps with 9 king size pillows to try and get comfortable.

*Every day is a nightmare. he has no life, he is in constant pain and cannot seem to find

a diagnosis and therefore does not have a treatment plan.


*He has undergone scopes, biopsies, colonoscopies, stool tests, blood work, MRA, CT

scans, MRI. Results show "inflammation". Serratonin was extremely elevated.

Testosterone is low. Has dx of mild gastroporesis.

*celiac disease and ulcerative colitis have been ruled out. Parasites have been ruled



** I am writing this for my relative. He is too sick to even stay fill out this info for you. Please help if you can.


Expert:  Internist replied 8 years ago.
When I first looked at your question I thought you might have one disease entity. If that is the case then I would be able to recommend a specific hospital that specializes in that particular disease. For example if you had Crohn's disease Mount Sinai in New York City is an excellent hospital for this. That is just an example. The complaints that you are relative has are too extensive and nonspecific to be a to recommend a specific hospital or University Center.

You may want to enter a specific question and see if you can get a specific answer and try that. If that is not acceptable to you I will opt out and see if another expert can help you.

*****Click ***** "ACCEPT" (GREEN) ***** or I do not get credit for my answer and Just Answer holds your deposit. Take a moment to leave a ***** POSITIVE ***** feedback which does not cost you anything. This response is for educational purposes only and does not substitute for a visit to your doctor or establish a doctor patient relationship.

Customer: replied 8 years ago.

Thank you for taking the time to address my question. The problem you identified is exactly why I asked for diagnosticians. To date a diagnosis has not been obtained and he has seen MULTIPLE physicians in and out of speciality hospitals in our state. I need to locate a institution/hospital/group of physicians that has the the time and the years of experience to shift through all the information and make a list of possibilities. Checking for each possibility as they go and ruling them out until a diagnosis is obtained. Finding treatment should then be obtainable. For instance, Shands Hospital and Cleveland Clinic state that records are discussed at a round table with all physicians from the department (ie GI) and all other physicians involved in the patient care (ie radiologists). That did not happen at either institute. I am seeking an institute/hospital/group of physicians that will actually do that. It has also been suggested that perhaps we need to leave the US and seek treatment in another county. Is there an agency that helps Americans with that? We need help and cannot find it. Do we have a hospital/institute/group of physicians in the US known for being able to dissect difficult medical cases and find a diagnosis? Again, thank you for your answer but I do not know what specific question to ask other than the original one concerning the location of diagnostician(s).

Expert:  Internist replied 8 years ago.
I am sorry I can not help you. I cannot recommend a specific place over another. You may desire a University setting and I would suggest when you make the appointment you make your needs known so that they will be willing to accommodate you. You don't have to accept as I took this question because I thought it might involve one specific Disease entity. I do not think it will be necessary to travel outside the country as there are many centers of excellence in this country.
Customer: replied 8 years ago.

Again, thank you for the time you spent answering my question.

Customer: replied 8 years ago.

My question was not answered. I still do not have any more info than when I originally asked my question. Thank you for taking the time to answer but you really did not help in any way.

Expert:  Internist replied 8 years ago.