Spiralling after GP appointment

[WoodforTrees]

I have had a dull ache - a bit like a muted stitch in my lower left abdomen for about a week. I started HRT five months ago and wondered if it was maybe triggering an inflammation of an ovary or something like that. I had a few days of bleeding about a month ago but Dr Google suggested this was pretty normal when starting Everol Conti.

GP appointment today, she had a quick feel and listen to my abdomen - it was a bit tender but she didn't find a lump and said it sounded like everything was working, but then then went straight to a FIT test to rule out bowel cancer. No other explorations.

I wasn't really ready for that so I asked if that's what she thought it was and she said something along the lines of 'probably not, but let's start with the worst thing and work our way down'. I am reeling a bit as I would have expected to explore things like a cyst/diverticulitis/kidney stones etc first so am wondering if this is normal for some GPs (ruling in/out a worst case scenario first) or if I have reason to be really worried.

I've not noticed any changes in bowel habits till today where I have been a few times but that's entirely likely to be down to the fact that I have gone from zero to terrified and I can feel my stomach responding to be feeling fearful.

I want to mention that a couple of weeks ago, the same GP referred me for a scan when I mentioned the bleed - despite my understanding being that it's quite common - so it may be that she is just very cautious and thorough which I cannot complain about. But none the less, it has come as a shock. I'm waiting on scan and now the FIT test results and I can feel myself unravelling a bit.

I don't know what I want from this thread, perhaps some assurance that this way round of diagnosing isn't entirely unusual and doesn't necessarily mean that GP is convinced that's what it is.

My GP was the same, I had pain and IBS like symptoms. She started with ovarian or bowel cancer, that certainly hits you hard..... but after tests, nothing.

MRI finally showed gall stones .

I think the reasoning is start with the worst, however unlikely, so not just so it can be ruled out, but if it is, then treatment won't be delayed.

Hang in there x

I used to be a patient at a wonderful doctor's practice and the youngish woman doctor was particularly thorough.
She would always refer me for scans and xrays and whatever. She called it the belt and braces. Making sure the worst scenarios were ruled out.

It's a nuisance OP, particularly waiting for results. But much better to have your issues taken seriously.

Completely understand why you're feeling the way you are but it is best practice to rule out the worst case scenarios first. In the unlikely event that it is something more concerning then it's best not to delay any treatments.

I think it's common to rule out the worst first. I had piles and my GP first sent me for tests to rule out anal and colorectal cancer before treating me.

Might it be that the FIT test is a first port of call for anything that might possibly be bowel related because it’ll be loads cheaper than a scan - do a cheap screening first for more info before going onto deciding what actual diagnostic tests would be most useful?

After reading an enormous amount of posts on other threads from people waiting months to years for their gp to do anything at all for them I’d say you have a fantastic doctor. Hopefully and more than likely it’s something simple or nothing at all. Blessings.

These are really reassuring responses. I appreciate nobody can diagnose or even hazard a guess, but it is good to know that starting at 'worst case scenario' isn't unheard of and not necessarily indicative of her 'gut feeling'. I just assumed we'd work our way up from the most benign possibilities, not down from the worst and so it has given me a shock.

You are right @Sbmpp My GP is quite a young woman and she is very responsive and proactive. My family and I know how lucky we are with our surgery. You get seen when you need to, they are quick to refer for tests and treatment, they even phone you at home to check how things are going and so on. We do get a level of care that I know is the exception not the rule in our under-resourced NHS surgeries in London.

I am not very brave with health stuff and I know I am going to feel sick, frightened and be snappy for the next week whilst I wait for results, but I do feel marginally less panicked after reading the responses.

I suppose with a FIT test which takes a few days to come back you rule out one cause quickly, whereas you can wait weeks for a scan.

Totally normal imo - every time I’ve had abdominal pain or bloating I’ve been sent for the ovarian cancer blood test and stool tests for bowel cancer. I much prefer this approach because then you can rest assured you haven’t been misdiagnosed with something trivial like IBS when actually it was cancer all along and it doesn’t get detected til it’s too late.

FIT test is quick and relatively inexpensive test from the NHS’ point of view so it’s worth ruling that out. Sorry it’s really horrible going through a scare like this but hopefully you will get an answer really soon.

Thanks all. I know you are all right and I am lucky to be getting the right tests and referrals. I was just completely blind-sided.

And I have a sick feeling every time the phone rings. They said a week for results but we'll call you if anything of note comes back... So every time the phone rings my stomach drops.

But it has honestly comforted me to know that it's not strange to be starting with the FIT test. So thank you again MNetters

Also a fit test is totally non invasive. No pain, even no appointments needed. It's an excellent test, really!

I’ve had a similar experience at the start of menopause, distended stomach and couldn’t eat much, typical warning for ovarian cancer. All tests were clear thankfully. One of my Drs suggested taking Optibac gummies (probiotic), it’s a game changer. I also take a teaspoon of turmeric mixed with hot water, coconut milk and honey, it is so good for your digestion, it’s amazing. Menopause causes some really strange goings on, it a whole new world 🤓

Wouldn’t you rather know it was cancer sooner rather than later? A fit test is so easy and will help rule things out.

Rule out the things that need an urgent response first. Then work your way round the ones that can wait a bit longer. Sensible.

It's totally normal for a GP on top of her practice to want to rule out the worst case scenarios first, and in this case, she won't even have to argue about the budget with anyone.

The bowel screening kits cost the NHS less than a tenner per kit. They're so cheap that once you turn 50, you get sent them at home every two years, just in case!

I’d be quite happy to start at the worse case and work backwards. My GP does it the other way around and it took years to finally get a life altering diagnosis