Let’s be honest, it can be overwhelming and even sometimes intimidating to see our gastroenterologist (GI). Don’t let that get in the way of having a good appointment. Setting some time aside to prepare your questions in advance can be helpful for you to stay organized with your diagnosis and also lets the doctor know how important this is to you. Here are some tips on what to ask your GI at your next appointment.
Questions to ask at my doctors appointment
- What part of my digestive tract does my IBD affect
- Note: Crohn’s can occur anywhere from the mouth to the anus (small intestine being a common area) while Ulcerative Colitis (UC) affects the colon (large intestine). UC can first present itself in the lower part of the colon (rectum) and may travel to other areas of the colon (sigmoid colon, descending colon, transverse, ascending colon, and cecum).
- Depending on the location of your IBD, nutrient absorption can be compromised.
- Can we recheck my anemia panel
- This is a good idea to check in general since blood count and hemoglobin levels can drop during active inflammation.
- Be sure all levels are checked. This includes a complete blood count (CBC) + B12, Ferritin, Saturation, Transferrin, Total iron binding capacity (TIBC) and others
- Can we recheck other labs: This can include specific vitamins that can be compromised with your IBD. Be sure to check Vitamin D3
- Many patients with IBD have suboptimal levels of vitamin D3 or are deficient. If supplementing, it is important to monitor levels and adjust accordingly.
- Is my treatment working for me and do we need to make any changes
- Asking your doctor about your current regimen can ensure that your therapy is helping you either get into remission and/or staying in remission.
- There is no reason to stay on medication if it isn’t working for you. An example would be a Crohn’s patient with ileitis who is taking Mesalamine→ this wouldn’t work for them since Mesalamine works in the large intestine and not in the small intestine which is where the ileum is located.
- Before starting a new medication, should we be checking any labs beforehand
- Some IBD medications including JAK-inhibitors and biologics recommend checking a lipid panel and tuberculosis before starting the medication. There may be other tests that are recommended as well.
- How can I check my inflammation without doing a scope
- Certain labs including fecal calprotectin, CRP, and ESR can be helpful when detecting for inflammation
- How often should I have a colonoscopy or other diagnostic testing
- The frequency of scopes whether it be a colonoscopy or sigmoidoscopy and imaging is dependent on your doctor’s recommendations. Some patients need a colonoscopy every year while others may wait every couple of years.
- For detecting IBD in the small intestine, procedures including CT scans, MRI, and ultrasounds can be performed.
- What happens if I’m allergic to this medication–what are my other options
- Your doctor may ask about your allergy to certain medications before you start a new treatment. We have a lot of different IBD medications to choose from.
- Do you have any nutritional resources
- This can be a good question to ask your doctor. It’s important for your GI to be supportive of you seeing a Registered Dietitian because we know how important nutrition is when it comes to IBD.
- If I’m trying to get pregnant, can I take a prenatal vitamin supplement
- Asking your doctor if your IBD is in a good place before getting pregnant is an important conversation for you to have. Some patients can flare during pregnancy while others don’t. Don’t let your IBD stop you from wanting to get pregnant and ask your doctor/confirm with them that it’s okay to take a prenatal.
- Anything new that you decide to take, whether it be a supplement or a new routine that you decide to do, speak to your doctor and update them.
- How can I avoid pouchitis and how is it treated
- If you have a j-pouch and continue to experience discomfort, it’s important to let your GI know.
- Antibiotics may be needed if pouchitis is experienced. It is also important to maintain good hydration due to the nature of inflammation. HERE is a good resource that we have concerning hydration.
- What’s the difference between my conditions versus other types of IBD
- How long does it take for Prednisone to start working
- For my next scope, can we try a different laxative/method of preparation
Better conversations w/your GI: Scripts for common IBD issues
Standing up for ourselves or what we like to call, advocacy, can be challenging at times. We’d like to think that our doctor knows what we’re thinking or what we want but sometimes it’s not that easy. It’s important that you have a doctor who really “gets you” and is open to having conversations with you that may present disagreement. Let’s take medications for an example. Remember that your GI’s goal is to get you into remission with the right medication that works best for you. While there are many options to choose from, not all will work for everyone. Medications come with unwanted side-effects and for some, may cause an allergic reaction. If for example you are looking to become pregnant within a certain time frame, it’s important to have this discussion with your GI. Certain medications should not be taken while pregnant and because of this, discussing treatment options is crucial. Let’s take a look at some examples below on questions you can ask.
- I am planning to become pregnant. Is there a different medication that I can take that is safer for pregnancy?
- I have a history of high cholesterol. Should I be cautious when taking this medication? Is there another medication within the same category that can be just as effective for me?
- Can we talk about the safety of biologics during pregnancy?
- What can we do if my medications are affecting my labs?