# 2 doctors 2 different opinions on colonoscopy



## svs14623 (Dec 12, 2003)

My son who's 15 has IBS, having a hard time finding a doctor to treat him in our area. Long story but ended up seeing head of GI department Kevin really felt comfortable with him, he can't see him anymore but the other adult dr said need colonoscopy to rule out more things. In mean time son having pain of 8 scale 1-10 for longest time yet -2 weeks not going to school with some D. The other dr who wants colonoscopy too busy too call and discuss till appt 5/27. Any suggestions or comments? My son wants to believe its just IBS as other dr told him. Thanks


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## bkitepilot (Dec 7, 2003)

Getting a colonoscopy is a good starting point to rule out other problems. Can you call this doc to get something for pain for your son? What about your family doc prescribing something for pain in the mean time?


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## svs14623 (Dec 12, 2003)

Belinda,Thanks for responding. After my inquirying, the GI dr (that wants colonoscopy) will give phx for a tricylic suggested amnitriptoline. Otherwise no dr suggested pain medicine. Would you consider the above medicine pain or what have you been on that helped? His pediatrician is looking into another antidepressant too see if it would help him sleep. Thanks Sandy


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## bkitepilot (Dec 7, 2003)

Amitryptoline is not a pain med is a tough one to get off of, not to mention it has a multitude of side effects. This med will help him sleep, but also will keep him sluggish during the day. It's a very old drug and I'm not a a supporter of it, because of the extensive side effects. Sleep is important, but managing the pain will improve his sleep ability. I believe he needs something...not sure what.... but definately something to manage the pain. The sleep will follow. Of course, they need to find the problem that is causing him so much pain.I'm so sorry he's going through this at such a young age. I hope something will break for him and give him some relief.


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## StillHoping (Sep 16, 2002)

Amitryptoline is not a pain med is a tough one to get off of, Belinda?







What are some of the side effects of Amitriptolene?My doctor has me on Valium and I REALLY DON'T LIKE taking that.It is also supposedly a tough drug to get off of but I would love to.I honestly don't think it is even taking an edge off of my anxiety level at this point.


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## bkitepilot (Dec 7, 2003)

Okay so I put my big toes in my mouth and this old drug has found some new uses. Besides assisting with pain receptors in fibromyalsia, I don't find where it helps beyond dermatological problems. I don't understand how it's going to help him with abdominal pain.AmitriptylineAmitriptyline is a tricyclic medicine that was once widely used as an antidepressant before being replaced by newer antidepressant medications with better side effect profiles. Other uses of amitriptyline include the treatment of insomnia, enuresis and chronic pain syndromes such as fibromyalgia. Amitriptyline and other tricyclic antidepressants are finding a place in the treatment of chronic pain and itch associated with some dermatological conditions. --------------------------------------------------------------------------------What is amitriptyline used for?Amitriptyline is useful in reducing the symptoms of chronic pain in the following skin conditions: Vulvodynia Vulvar vestibulitis Dyaesthetic vulvodynia Shingles and post-herpetic neuralgia Pain arising from these conditions is defined as sympathetically maintained pain (SMP). The pain is usually described as having a burning sensation and is often in response to stimuli that does not ordinarily cause pain. This pain originates from the nervous system. Amitriptyline appears to be effective in reducing this type of neuropathic pain in doses lower than those used to treat depression. side effects of amitriptyline include: sedation drowsiness dry mouth blurred vision constipation difficultly urinating dizziness weight gain heart rhythm disturbances. These effects may occur in up to 50% of patients and elderly patients are at greater risk. Intolerance of these effects often leads to discontinuation of the drug. Other tricyclic antidepressants such as desipramine and nortriptyline may be better tolerated than amitriptyline. It may be dangerous to take amitriptyline with a monoamine oxidase inhibitor (MAOI) antidepressant medication or within 14 days of discontinuing a MAOI. Amitriptyline may not be suitable for people with certain medical conditions. Tell your doctor if you have had any of the following health problems: Heart disease Seizures/epilepsy Glaucoma Urinary retention Overactive thyroid gland Drug-related hyperpyrexia. Amitriptyline is dangerous in overdose.These are just a few of the side effects. Sorry it was such a long post. (a bit of cut and paste from a simple site)In my PDR the side effects are bit more extensive. You have to wean off this drug and also valium too. Valium is an excellent muscle relaxer and is known to assist with bowel issues. For anxiety, Xanax is a wonder drug. (also a controlled narcotic)


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## NancyCat (Jul 16, 1999)

Just my opinion. Amitryptiline/elavil does have side effects but when prescribed for IBS/abdominal wall pain its given in really low doses (10 mg to start)so the side effects are minimal (though of course some people are more sensitive to drugs than others). It takes about 4-6 weeks to work and sometimes you need to adjust the dose. I take it and found that it did make me tired at first but taking it at bedtime took care of that. It is a very old medication and was used mostly for depression but at much higher doses (150-175mg). I know you have to wean off of it but thats true about many medications and not a problem. Valium is very addicting and though it is an effective muscle relaxant I believe it is not as effective in relaxing the muscles involved in IBS pain. My IBS pain was an 8 and the elavil has brought that down to a 3-4 which while not curing it, controls it and makes it bearable. The newer antidepressants (zoloft,paxil)are also used for IBS pain, again only in very low doses. I think they all can have a slight sedative effect but are usually just given at night if thats a problem. I'm sorry that your son cant see the DR who he was comfortable with again. I've had IBS for over 20 years and only in the past 2 years have found a DR who "gets it". It makes all the difference in the world!!!! There is more information and personal experiences regarding elavil and other meds in the part of the board about antidepressants. Hope this helps


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## svs14623 (Dec 12, 2003)

Belinda and Nancy,Thanks for your replies.He's been on amnitriptolene for 2 weeks now. First of all they started him on 25mg right away. I have been on nortriptolene for fibromyalsia and started at 10mg. I inquiried when picked up w/pharmacist he said it was low. I'm just so tired of questioning everything. I was never that type of person before. Oh well. He seems to be able to do some school work during the day and sleeping a bit better but still not in school. He still has pain. Nancy, you said took several weeks for you?He had the colonoscopy done on 21st. The dr only said he did great and they found 2 red areas which could be from his medicine. One area is where he has his pain around the belly botton. I never thought to ask which medicine. I have a call in on that. So we have to wait up to 2 weeks for biopsy. That seems very long? Does that sound right to you?


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## NancyCat (Jul 16, 1999)

Yes, it took me a good 4-6 weeks to feel that the medication was working. It can be frustrating, especially since its your child, you want the medication to work instantly. (When my son was little (he's almost 17) and had an ear infection the pain got better after the FIRST dose of amoxicillin). 2 weeks sounds alittle long to wait for biopsy results, you might get them closer to 1 week. I used to wonder why it takes so long for these results, I thought there must just be some line of specimens that were backed up because there weren't enough people to look at them. A DR told me that the reason it takes so long is because the tissue has to go thru a process or many processes(sometimes they stain tissue and have to wait while it does its thing so to speak)and that its not because places are understaffed or lazy. Is he taking any meds that are red? I know that certain types of meds and foods (red jello, hawaiin punch) show up as red areas. I would imagine that if the DR was concerned about these red areas he would tell you. But its good that you have a call in to clarify things. I always request a copy of the report. Dont feel wierd by questioning people, Dr's and pharmacists. These people work for you. Unfortunately today, in my opinion and experience you have to be proactive regarding your health or the health of your loved ones, or you can slip thru the cracks. It can be quite a fight sometimes. Hope this helps


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## svs14623 (Dec 12, 2003)

Nancy,Thank you for the encouragement. He was instructed not to eat red or purple for few days before and he didn't. His medicine is small yellow tablet. He was on dicylomine and levsin (under tongue for several months before) both white. I will ask for a copy of the tests, it didn't even cross my mind to. I really have to work hard on being aggressive with the Drs and school, but I know I have to for his sake. I see you're from MA, I was thinking of bringing him to Boston's childrens hospital in July. Have you heard good things about GI department. Just waiting to see the results. A mom I got talking to brought her daughter to Mayo in WI, they did everything in a week very organized. Sorry got off track. Thanks again.


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## NancyCat (Jul 16, 1999)

I have heard wonderful things about the entire Childrens Hospital, but i'm not familiar with their GI dept. My son sees an orthopedic surgeon there and actually sees him in the Lexington office. If you go to Childrens in Boston, be prepared to wait, but they make the experience so geared to kids and pleasant that its not bad. It always seems to take many weeks to be seen at Childrens, you might be able to get him in faster if your/his primary doc arranges the appointment for you. I go to the Center For Digestive Disorders at Boston Medical Center (old Boston City Hospital/Boston University Medical Center/Medical School). They are fantastic and have helped me more than anywhere else has. I think its because they totally do "get it" about IBS, I'm very comfortable with my GI, he is great. I am going again at the end of June and will be happy to ask my GI who/where he would reccommend for a 15 year old. I've never seen a child there when I've gone. I'll also ask my husband (he is an OR nurse at BMC)to see if he can ask the docs if there is any one there who does GI with kids/adolescents. They will probably say Childrens but I'll try and find out. Other than making sure that your son gets the proper tests and diagnosis, finding someone he feels comfortable with is really important, in my opinion, as in my experience IBS is chronic and it helps so much to have a health care person who knows you and is in your corner consistently. I'm sure there are rotten apples in every barell but I'd imagine that all the docs at Childrens are skilled in communicating with kids and they like them too which is no easy feat. My son is almost 17, Just started driving and drives me crazy! See what you have to look forward to?





















I'm getting off track too, but I would suggest that you try and get an appointment for him, if you call now you might be able to get him seen ###CH in Boston. The Lexington facility seems to book 3 months out from when you call. They are very strict about referrals if your insurance requires them and will make you pay $50 if you dont have one in their computer when you get there or they won't see you. Get all of his records from other docs and the report from the colonoscopy. I had reddened areas in my upper endoscopy, which they termed mild gastritis but I'm not sure what red areas in a colonoscopy mean, inflammation? hope this helps


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## svs14623 (Dec 12, 2003)

Nancy,I'm so appreciative of your offer to ask about Drs. I had called BCH a few weeks back to ask about when they were making appts and it was only 3 weeks. In Rochester it took 4 or 5 mo to get his first appt. I asked his GI dr now about going there he just responded you already went to Children' here. I don't feel there's any comparison as Boston gets ranked by US news-I think. We're still waiting on colonoscopy. I called week later and was told 2 weeks. They're a type office that sticks to guidebook. I don't like them either, but what afraid of is Boston so far away. We do have relatives near by. HOw often do you go for visits? Do you call a lot with questions? I tend to, I have to say childrens Roch was good about taking calls but really just listened almost like recorded replies. But new dr can't ask any question his office screens and says he's too busy to talk to us. I'm just complaining now. I just want answers. Well thanks again for your offer. New question, Have you ever tries hypnotherapy? I was reading that it works well. I was going to have him try biofeedback not too sure about that since read about hypnotherapy? Off the topic again. Must be tired. --Sandy


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## NancyCat (Jul 16, 1999)

Sandy-My sons pediatrician usually sends him to someone at Childrens if he needs a specialist. The school nurse thought he had scoliosis in 6th grade and he saw one of the orthopedic surgeons at the Lexington office. Till he was 16 he had to go every 6 months and get spine xrays once a year. The last time I was there his scoliosis had resolved/he doesnt have it anymore and doesnt need to go back. I never called them with questions, but I did write them down before hand a few times. I dont think I'm clear as to what you have to wait 2 weeks for. Usually (but I'm not positive)they read a colonoscopy as they do it, at least in my case both times they gave me the results before I left. However the 2nd time I had a polyp which they removed and biopsied and they said i had to wait between 4-7 days for those results. Did they do biopsies of your sons colon? Of the red areas? I work for a DR (eye dr) and if someone told a patient or family member that the DR was to busy to talk (he probably wouldn't call the pt right back but would read the message THAT DAY and write a reply for one of the receptionists to give the patient)that staff member would be FIRED on the spot!!! Is this a pediatric dr? You would think that they would be used to dealing with anxious parents and that they woudnt be so rude. I don't blame you for wanting answers, you are the consumer, the DR works for you...Yes I have tried hypnotherapy, Mikes tapes actually from this bb. I dont know if I would go so far as to say that yes it works like a magic bullet, but I think that its another tool to battle IBS with. It helps. I was interested in biofeedback myself as my GI said that he thinks I may have a pelvic floor dysfunction that is contributing to my IBS. But he said that in his experience there werent many treatments other than biofeedback that were effective and that even that wasnt so good. Personally I dont think I could concentrate to have a bowel movement in front of people with electrodes in my bum (which is where they put them). So I'll not pursue it anymore. I can understand why coming to Boston is a hassle for you. You could always make the appointment just so you have it and then wait till you see what the colonoscopy results and DR's reccomendations are. I'm sorry you have to wait so long and I apologize as one who works for a dr, for those rude people you are dealing with


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## svs14623 (Dec 12, 2003)

Nancy,Yes he did have biopsy. The dr (adult GI) called today. He said they were not normal but not really abnormal. He wants him to have the capsule endoscopy. (camera pill). I asked what the results meant he said he wanted to further test and clarify. He would say he has Crohns not IBS. I'm still so confused on his explanation. I just don't want to talk to drs anymore. Well I have to decide if have him continue or go elsewhere he has the office help that says he's too busy. I wish school was all done with. He's been doing great all year even though he's always playing catch up.(not great on the nerves) He's honor student but now this last quarter just happy to pass. The school has been so topsy turfy about it and disorganized. I can't get answers from them at least consistant ones. Sorry, just on my mind. Good luck with your coming appointment. I sure wish scientist would find more out about IBS so they can help so many suffering. Thanks for your help.Sandy


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## NancyCat (Jul 16, 1999)

Sandy-I'm glad that the dr called you today. His practice/hospital he is affiliated with, must be pretty much up with the times if they offer that camera pill. I beleive its pretty new and used when other tests are inconclusive. I believe it was on 20/20 with Dr Tim Johnson or else it was on our local news. From what you said earlier about some red areas I bet that is what is making this dr lean towards Crohns as opposed to IBS. To the best of my knowledge IBS has some of the same symptoms as Crohns, ulcerative colitis and ilieutis which are all inflammatory bowel diseases. However,IBS doesnt produce any inflammation , so you dont see any on colonoscopy. The biopsies should identify or help to identify what the inflammation is from and I think the more they try and identify it the longer it takes just cause the process takes time. If it was me I would continue with this DR since you/your son have already come this far and once he has the camera test(which I think tests the entire gi tract) its a question of intrepretation, there isnt much else the docs at childrens could do for your son testing wise I wouldnt think. If he has Crohns I'm pretty sure that there are medications that can keep it under control. Alot of people who have it get flareups but they are ok in between. Write down any questions you think of so you can ask the dr next time you speak to him. Good luck and keep in touch.


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