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I'm Looking For A Gastroenterologist To Review A Written Summary

Posted on Wed, 24 Feb 2021

Question: I'm looking for a gastroenterologist to review a written summary of my problem and recommend the appropriate lab tests to investigate why my problem exists. And of course to provide the lab requisition to go have the test performed.
I've attached documents showing a basic summary of my problem and what's been done so far. In a separate file I've listed medical tests ran such as colonoscopy, spleen sonogram, ect. However, it would take hours to upload the results of those medical tests one by one. Please provide a method to upload a single zip file of about 200mb so I can send you everything in a neatly organized folders containing MRI pictures, microscope slides of bacteria samples, lab test result pdf files, ect. If needed I can upload these documents to a 3rd party cloud service and simply send you a download link for a single zip file.
And in case it wasn't made clear....My goal is to have a gastroenterologist review my medical history and provide a lab requisition for 1 or more tests to further investigate my lifelong chronic constipation.

Answered by Dr. Ramesh Kumar (6 hours later)

Brief Answer:
Mail reports directly to me at YYYY@YYYY .

Detailed Answer:
Hello and thank you choosing "Ask a Doctor" service for your query,
Have seen the two attachments,
I would like to go through the complete file of yours(mail me at YYYY@YYYY ).
Please also mention what your gastroenterologist's have suggested you?Diagnosed you with?
Waiting

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ramesh Kumar (4 hours later)

Sending email with Google Drive download link now... File is a single Zip file of about 180mb in size.

Answered by Dr. Ramesh Kumar (19 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hello and Thank you for sending all data's reports and microscopic images,
After going through your complete history the word that strikes me at first is that you have this problem since birth.
There is a possibility that the nerves related to movement of a particular part of intestine is not functioning well/Ganglion is absent in that part/Nerve as a whole is absent or under performing....The problem is that exact movement could be seen only by surgeon doing colonoscopy(or video).
My suggestion would be to go for a colonoscopic and rectal biopsy to reveal if nerve tissues are normal.
A rectal manometry test should also be done
Discuss this with your gastro and revert me back on what he/she thinks!
Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (13 hours later)

Before Anorectal manometry do you think it would be advantageous to perform some kind of contrast imaging test first to see where along the GI tract fecal matter is stopping? Would you be able to create a doctors referral to a clinic that can perform an Anorectal Manometry or other proceedure in my area? XXXXXXX USA 78232 area.

Answered by Dr. Ramesh Kumar (8 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Yes a contrast guided CT and MRI can be helpful in finding out the functioning of nerves,any type of obstruction/growth etc.
Umbrella approach is best in your case i.e to exclude possibilities one by one.
Thank you!

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (14 hours later)

Sounds good. Are you able to setup a clinic referral for a procedure to be done in my area? I live in San XXXXXXX XXXXXXX USA 78232.

Answered by Dr. Ramesh Kumar (7 hours later)

Brief Answer:
Follow up.

Detailed Answer:
I am really sorry but I don't think that's allowed on this forum.
Rectal biopsy or Manometry had never been suggested by doctors earlier.
What dose of lactulose or sodium picosulate have you used till date?
Thanks!

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Above answer was peer-reviewed by : Dr. Vaishalee Punj