Thursday, August 10, 2017

The doctor and the prescription

The good news about my recent colonoscopy and endoscopy is that my gastroenterologist saw no sign of either Crohn's Disease or Celiac Disease.

The bad news is that she did see a hiatal hernia (which is almost undoubtedly contributing to my acid reflux) and a stomach ulcer.

The good news is that the ulcer is already partially healed.

My doctor recommended that I be treated for about two months with one of those stomach-acid-reducing medications--I believe she mentioned Nexium, Prevacid, and/or Prilosec--then undergo another endoscopy to determine whether the ulcer was cured.

Having already been told in the Recovery Room that I had an ulcer that was partly healed, I'd done some research on the internet, and made a counter-proposal--since the healing had already begun and I saw no reason to "bring out the big guns," I would use probiotics and deglycyrrhizinated (deglycyrrized?) licorice, rather than prescription medicine, to complete the cure.

That's where our conversation turned, to my mind, a bit weird:  My doctor made it crystal clear that she had no intention of performing another endoscopy to confirm that my ulcer was cured unless I consented to the treatment that she was prescribing.

Ensuring that my ulcer was cured seemed to be of less concern to her than ensuring that I followed her recommendation to the letter.

I'd be very interesting in reading your reactions, particularly if you're a physician, pharmacist, or other health-care provider.


Anonymous Anonymous said...

hmm, is there any chance you can switch doctors?
If not then obviously I would consider telling the doc I would follow her protocol and give myself time to heal before going in for follow up.
Sorry I am not a medical professional, just a not so patient person not interested in indulging poor health care.

Thu Aug 10, 08:08:00 PM 2017  
Blogger Shira Salamone said...

As luck would have it, I already switched doctors--the gastro in question is my new one. Looks like my next step may be to ask friends and family which gastro(s) they would recommend.

Fri Aug 11, 12:39:00 PM 2017  
Anonymous Anonymous said...

the alternative OTC supplement you mentioned, the study cited is from 1985 before any of the meds your MD is recommending were even invented yet.

look at the study. it involved a drug no longer used. in addition prevacid, nexium etc have a different mechanism of action from cimetidine...

in this case, it is best to take the med...

Fri Aug 11, 01:01:00 PM 2017  
Blogger Shira Salamone said...

Anon # 2, I'm not convinced that taking the med is best--acid-reducing drugs can create nasty long-term problems. (One friend of mine ended up in the hospital when acid-reducers made her digestive system malfunction.) I think a second opinion might be warranted.

Fri Aug 11, 02:02:00 PM 2017  
Anonymous Anonymous said...

an endoscopy is a medical procedure that carries risks. doing one unnecessarily when there is has been no intervening medical treatment to heal the ulcer, in your doc's mind, is an unnecessary risk in the risk/benefit analysis.

You're free to do what you want. But supplements aren't drugs. Drugs get approved due to two adequate and well-controlled clinical studies. Supplements get sold because they have been present in the food supply or if they can demonstrate a general sense of safety. The HuffPo article doesn't demonstrate safety or efficacy of the licorice product. That study is at best suggestive that further research needs to be done.

Long term use of PPIs do present some risks. But short term presents fairly modest risks. From the doc's perspective, she's probably pretty happy to be rid of a patient like you. Your google search doesn't replace her four years of medical school and residency/fellowship.

Tue Aug 15, 11:19:00 AM 2017  
Blogger Shira Salamone said...

Sorry I haven't responded, but I've been insanely busy at the office. I'll take your advice into consideration.

Sun Aug 20, 05:05:00 PM 2017  

Post a Comment

<< Home

<< List
Jewish Bloggers
Join >>