Patient Information
Dr Alex Simring is a Gastroenterologist and Hepatologist who specialises in digestive diseases.
What is a gastroenterologist?
A gastroenterologist is a specialist who is expert is dealing with problems related to the digestive tract. Some common problems that you can get help for include:
- Acid reflux
- Difficulty swallowing food
- Indigestion or stomach pain
- Bloating and wind
- Abdominal pain and cramps
- Diarrhoea and Constipation
- Rectal bleeding
- Weight loss or loss of appetite
MEDICAL HISTORY
When you meet your gastroenterologist, they are likely to ask a series of questions to determine whether there are any problems with digestive health. This will occur at the initial consultation, so it may be helpful to be prepared to answer some of the following questions.
You will probably have been referred to see a gastroenterologist by your local GP. The referral letter from the GP will outline what problems you have been having with your digestive tract as well as providing a summary of your overall health. The referral letter may form the basis of the initial questioning.
Remember, the reason that your doctor is asking questions is so that they can work out what is wrong with your digestive health (diagnosis).The doctor may then need to organise further testing (investigations) before starting you on treatment to get you better (management).
1. INTRODUCTION
“My name is Dr Alexander Simring, gastroenterologist and hepatologist. I have been asked to see you by your family doctor regarding the following issues. Can you explain to me in more detail some of the problems you’ve been experiencing?”
Or, maybe the introduction could run along the following lines: “My name is Dr Simring, a digestive diseases specialist. I have a letter from your GP asking me to see you. Would you like to tell me more?”
2. SYMPTOMS
Your doctor will want to know why you have been asked to see them. Don’t assume that everything is written down in the referral letter from your local GP. Try to provide a brief summary outlining what issues you have been having. Don’t start off by going into too many details, but try to provide an overview.
“I’ve come to see you today because I’ve been experiencing abdominal pain”.
The gastroenterologist will ask you to describe these symptoms in more detail, or may ask you a series of questions. Some of the questions that are normally asked include:
– describe the nature of the problem
– how long you have had the problem for (acute or chronic)
– has the problem been getting worse recently
– what things aggravate or alleviate the problem
– do you have any other associated problems
– have you had tests for this problem before
– have you had any treatment for this problem before
PATIENT: “I’ve had a pain in my guts for years”
(what the doctor would prefer to hear)…”I’ve had a pain in my gut for years, but its been getting worse over the past few months. It feels like a burning sensation in my stomach but seems to get better when I have something to eat or if I drink some milk. The pain got pretty bad so I went to the Emergency Department last week. They gave me a ‘pink lady’ and told me to see a gastroenterologist. I had a similar problem many years ago and they did an endoscopy and gave me treatment for an ulcer”
3. GENERAL DIGESTIVE HEALTH
Your gastroenterologist may then go through a checklist of questions regarding your general digestive health. The following are some questions they may ask you:
– Do you have any problems eating a meal? Do you suffer from pain, burning, nausea, bloating, fullness when eating food?
– Have you had a recent loss of appetite or loss of weight?
– Do you suffer from heartburn?
– Do you have any difficulty swallowing food or water?
– Do you have any abdominal pain or discomfort?
– Can you describe your bowel habit? How often do you open your bowels to pass a motion. Do you suffer from constipation or diarrhoea? Is the stool consistency normal, or do you have either hard stool or watery stools.
– Have you experienced rectal bleeding, or passed black tarry stools?
4. PREVIOUS INVESTIGATIONS
Your specialist will want to know if you have had any previous testing (investigations) or if you have seen a doctor for these problems in the past. It would be helpful if you could bring in a copy of any tests that have previously been done, such as blood tests, xrays, abdominal ultrasound or CT scan and results of endoscopy or colonoscopy if preformed.
5. MANAGEMENT
It is important to have details of any current or previous medications or treatments that other doctors may have prescribed. This will provide useful information as to what has been tried in the past, and what is likely to work or not work now.
6. GENERAL MEDICAL HISTORY
The gastroenterologist may also want to know more information about your overall health. Make sure to let your doctor know about any other medical conditions that you have, or if you have previously had surgery. Provide an up to date list of medications and let your doctor know if you have any allergies to medications. Your doctor will also be interested in whether there is a history of any illnesses in other family members.
7. EXAMINATION
Your doctor will perform a thorough medical examination, with particular focus on the gastrointestinal system.
DIAGNOSIS
At the conclusion of your initial consultation, the gastroenterologist should have a few theories regarding what the problem may be due to. It is likely that further testing may need to be done to help work out what the problem is. Sometimes, it is too early to speculate as to what the problem is before further testing is undertaken.
Remember that the ultimate aim of seeing the specialist is to try to get you better. This is often not possible on the first meeting. Your doctor should at least provide an indication of what they think the problem is, and what the next steps are.
” I think you have an stomach ulcer, but I’d like to perform an endoscopy to look into the stomach to confirm my suspicions. I’d like to start you on medication while we are waiting for this test to be organised. I’m concerned about how severe your pain was recently, and you would need to return to hospital if you have more severe pain. I also want you to go to hospital if you develop rectal bleeding, particularly if you are passing black tarry stools or feel feint or dizzy”.
Every doctor will have their own particular style. You should not feel afraid to ask questions, particularly if there is something you don’t understand. Your doctor is trying to work out how to get you better by asking you questions, performing a bedside examination, and possibly ordering further testing. The information you provide the doctor is the most crucial part.
Dr Alexander Simring has expertise to help diagnose and manage the following digestive diseases:
- Reflux disease
- Peptic ulcer disease and H.pylori
- Coeliac disease
- Irritable bowel syndrome
- Colon polyps and colon cancer
- Ulcerative colitis and Crohn’s disease
- Haemorrhoid treatment
- Fatty liver disease
Dr Alexander Simring offers the following services:
- Medical consultation
- Gastroscopy
- Colonoscopy
- Haemorrhoid banding
- Small bowel capsule endoscopy
Dr Simring is an adult gastroenterologist and only consults patients age 18 and over.