When Should I Get a Second Opinion?

Some time ago, I saw a woman who traveled across state lines to see me to receive yet another GI opinion. She had been having daily gastrointestinal symptoms for a decade despite an exhaustive and repeated series of tests arranged by multiple different gastroenterologists.  Her symptoms remained unexplained and I suspected that they were unexplainable.

I have seen many patients like this who suffer from chronic abdominal pain, nausea, bloating, bowel issues and other digestive complaints who have been evaluated by prior competent gastrointestinal specialists.  It is terribly frustrating when there is no explanatory diagnosis to explain the misery.  Sometimes these patients ask, ‘Am I crazy’?  Of course, they are quite sane.  Many common digestive symptoms simply don’t light up on our diagnostic tests.  Bloating and nausea, for example, are unlikely to be explained by a scope exam or a CAT scan or other studies.

So, what should these suffering individuals do?

So, what did I tell the woman who had been suffering daily for a decade?  She had seen at least a half a dozen gastroenterologists, none of whom could crack the code.  She was well beyond the proverbial second opinion.  Her symptoms were unchanged and unexplained.  Here’s what I advised her.

First, I acknowledge that it was always possible that a diagnosis has been missed since we gastroenterologists are members of the human species.  But I felt this was unlikely after multiple evaluations by qualified practitioners.  We needed to address the reality that relief was not going to emerge from the gastroenterology universe and I discouraged her from continuing to seek succor there.  In other words, my hope was that I would be the last gastroenterologist she would consult with. 

Sometimes you need to change direction.

She needed to pursue other healing pathways.  Open-mindedness would be critical.  It was past time that she consider disciplines such as Functional Medicine, Integrative Medicine, Naturopathy, Acupuncture and other Complimentary Medicine alternatives.  She simply had to choose a different direction because she had been on a very long road to nowhere.

While I could not promise success, I felt that new pathways at least offered hope.

I couldn’t advise her on where to begin her healing journey as I did not feel qualified to do so.  If she agreed with my advice, then I encouraged her to begin researching the options and to involve her treating physicians in the process.  I truly hope that she will find some measure of relief. 

When the same approach in medicine or in life fails repeatedly, then try new.