Dismissive GP?

[MarchOfTheMurlocs]

Not asking for a diagnosis per se, just wondering if my GP is being dismissive and what I should do.

For the past couple of months (increasing in frequency in the past month or so), I've been experiencing:

1. Bloating (ranges from mild to a severe, most days)
2. Feeling 'full' despite not having eaten anything or having eaten very little (daily)
3. Low grade stomachache that gets way worse after food (couple times a week)
4. Nausea especially after food (usually with accompanying point 3)

I haven't made any changes to my diet or lifestyle. No new stressors.

Went to my GP for the first time a couple of weeks ago, and he told me it was just PMS even though I've never experienced such symptoms in the past. Went again on Thursday (made sure I was nowhere near my period) and he told me that if it's not PMS it's probably IBS and that the only thing I can do is monitor my food intake.

I primarily eat fish, eggs, bananas, pineapples, tofu, green beans, tomatoes, prawns, kimchi, and have a cup of jasmine green tea once or twice a day.

AIBU to think my GP is being dismissive? Surely I shouldn't have to spend the rest of my life dealing with almost daily bloating, fullness, nausea, and pain?

Hes not suggesting you spend the rest of your life bloated and in pain, it's been a couple of months, thats hardly anytime at all, and you've only been to see the GP once! Not dismissive at all, your diet sounds very limited and restricted, look at broadening what you eat. Take some pro biotics, keep a diary, then return if no improvement.

Honestly the amount of scaremongering on this thread is ridiculous.
If GPs ordered investigations on all patients presenting with likely IBS then patients with serious red flag symptoms would wait even longer than they already are for urgent investigations.
The chance of the OPs symptoms being serious is vanishingly small. I do think the GP should have safety-netted and asked to see again at a fixed time point as I say/
Armchair GP bashing seems a MN sport-and I think the majority do a fantastic job in spotting those patients who need referral to a gut specialist like me.

It costs about £200 to see a Gastroenterologist privately, that’s what I would do.

Yep and then £200 for bloods, £700 for upper GI endoscopy, £1500 for colonoscopy and £300 for US.
Still want to go ahead?

It sounds like gastritis to me. I had this and took PPIs and ate a very bland diet with tiny portions for a month or so and it went away.

But GP also did blood test to rule out ovarian cancer and I bought my own FIT test online to test for bowel cancer as I've had breast cancer previously so they are more thorough with me now.

YES - if only to rule it out. The symptoms you describe could be ovarian cancer. They're probably not, but you do need to be certain about this.

My partner had the same symptoms in 2004. Fortunately, her male GP took it seriously, referred her and she was in hospital having a total abdominal hysterectomy within a short time. It saved her life.

What age are you? Have you had blood tests recently? I don't think anyone here can dismiss the GPs approach given they have more Information about you.

Have you tried any remedies for IBS? e.g Buscopan as that may relieve symptoms if ibs.

IBS can start during midlife so it doesn't need a change in diet - just a change, such as hormones, which is why your age could be relevant. Why not post on General health to ask for advice.

I just don't understand the GP bashing. Most are very cautious as their livelihood depends on it. If you feel your GP surgery is consistently dismissive then change to a different practice.

All of that can be done on the NHS. If it was considered urgent the gastroscopy would be within a few weeks on NHS, same for colonoscopy. Although a Fit would be done before a colonoscopy was even considered anyway. Bloods can be requested via GP. Good consultants find ways and means to help the patient if they are not insured.

To answer some questions, had an endoscopy almost 5 years ago for a similar issue but without the bloating and fullness, just the constant stomachaches and nausea which I've been having since sixth form. Nothing serious but gastritis and a hiatal hernia.

I'm 30. Think I'm a bit too 'young' to be typically considered for anything serious statistically speaking but my maternal aunt was diagnosed with ovarian cancer at around 60 (caught early, thank god) so am just a bit peeved that GP immediately attributed it first to PMS and then IBS after 10 minutes when the bloating and fullness is not normal for me at all having never experienced either ever before the past few months.

Don't think it's anything serious but will push for a blood test and ultrasound when I meet with the second GP.

MissyB

That contravenes Private Practice Policy and doctors can be disciplined for doing what you suggest.

Patients are not able to have move between private and NHS and back again. Nor are they able to be advantaged on the NHS by seeing a consultant privately.

Sounds like a good plan - hope it all goes well and that you can get a diagnosis and treatment plan soon.

If it is IBS then I would really recommend the FODMAP diet - it’s been a game changer for DD. She decided to stay on it because it worked so well and she’s doing brilliantly after an absolutely miserable few years.

“Subject to clinical considerations, private consultation should not lead to earlier NHS admission or to earlier access to NHS diagnostic procedures"

And

"Any private patient who wishes to become an NHS patient must not gain any advantage over other NHS patients by doing so."

And an absolute no-no is asking the GP to request private bloods using NHS funds

What treatment did you get for the hiatal hernia ?

The dietician warned me not to stay on the low FODMAP diet for longer than 8 weeks. She said it isn't good for you long term.

None. Mine is small-ish apparently. Was given something for the inflammation (can't remember what) but other than that was just told to eat regular meals and try to stay away from spicy food.

If a patient is in clinical need of a test which is available on the NHS, and that need has been identified by a clinician, the patient therefore meeting the criteria, then any NHS provider would be on sticky ground refusing it.

This definitely sounds like a flare up of gastritis to me. I’d try a PPI as I said before.

MissyB1

I didn't say that. I said you can't in effect "jump the NHS queue" by going private, nor can you move more than once between sectors.

If I see a patient privately who needs tests but can't afford these then I refer back to GP to organise a referral back to me on the NHS.

If this is the triaged for urgency with all NHS patients if it meets 2ww criteria for example.

Try keeping a food and symptom diary in the run up to the appointment. It could be helpful to have a bit more info for the Dr as well as yourself. Turned out the very healthy seeds and grains I was eating, were getting trapped in my bowel and causing all sorts of probs. I'm not saying that's the issue here, just that I'd not put it together before as, to me, I was just eating my usual diet.

I should add, buscopan helped with symptoms till we sorted out the cause.

DD got the same advice - reintroduced foods with the support of the dietetics dept and decided that she preferred being on it as her symptoms stayed settled. She may reintroduce it in time, but she needs to control it to be able to carry on working 13.5 hour shifts. She’s fit and healthy, and none of the horrendous symptoms she used to have.

Definitely get advice from a dietitian - I can only say the it worked very well for DD. It doesn’t work for everyone though.

Apologies for derailing, this is not what this thread is about.

Coeliac disease?

www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/

Book yourself a private abdominal ultrasound on line. Prices range from £65 to £300 so shop carefully. Avoid private hospitals they tend to overprice, clinics are more competitive. When GP's are dismissive give, them the outcome not the symptoms. GP's also tend to be loyal to each other so if you do want a 2nd opinion a trip out of the area helps e.g. Channel Islands have good GP's, cost around £65 if you're not a resident (locals pay £40) but they can't refer you for free secondary care. I wish we did pay something for GP consultations and were given a receipt by the receptionist which read 'Thank you for using this practice, please come back again').