Thursday, 28 September 2017

Unfortunately, if multiple investigations and specialists haven’t given you a diagnosis then a random stranger on the internet won’t be able to either.
The details of your particular case are irrelevant. Let’s instead focus on the important question What am I supposed to do when doctors can't find what’s wrong with me?”
The answer lies to this question lies in understanding that you are asking a very different question than the one your doctors are trying to answer. You want to know what is wrong with you. You want a diagnosis to explain your pain. You want a label you can research on the internet. You want a cure. This is perfectly understandable. It is not a criticism.
However, you need to understand that doctors are not trying to answer the same question. They are searching for something they can fix . Whilst diagnosis is an important part of medicine, it’s not what we’re really about. Ultimately, we don’t care what label explains your pain - we just want to know how to treat it. The real reason we need a diagnosis is because it dictates treatment.
You are asking what is causing your abdominal pains. Your doctors are trying to find something they can fix. You're asking a Yes or No question. When the answer is Yes, then their job begins. It’s the gastroenterologist’s, or GI Surgeon’s, job to fix pain that is being caused by the gastrointestinal system. Unfortunately, when the answer is No, their job is complete. There’s nothing in your gastrointestinal tract they can fix to cure your pain. If you then try to ask them, “Well, what IS causing my pain?” their answer will be “Not your gastrointestinal tract.
Before exploding in anger over this ineptitude, please first consider all of the questions that Specialists have already answered for you. Let’s focus on the amazing results of your investigations. Your X-rays, CTs, and scopes have not found anything to explain your symptoms. This is fantastic news and I trust you’re overjoyed.
You have: No bowel cancer, no diverticulitis, no colitis or inflammatory bowel disease, no ischaemic bowel, no ovarian cancer, torsion or ruptured cysts, no uterine cancer or fibroids, no testicular torsion, no incarcerated hernias, no leukemia or lymphoma, no kidney stones or cancer, no ectopic pregnancies, no abscesses, no hemorrhages or hematomas, and no aneurysms or dissections.
Congratulations - you are now in a far better situation than a lot of people who saw those same specialists with left, lower abdominal pain.
Your specialists have put in a lot of work, and answered a lot of questions. In fact, the only question they haven’t answered is “What is causing my pain?” And, as stated above, that’s not their job.


Now the fact that gastroenterologists and urologists haven’t found the cause of your pain leaves us with multiple possibilities:
  1. It is possible that your specialists are hacks and they’ve missed something. You should not blindly trust a doctor - they are human and humans make mistakes. It is possible there is a problem with your gastrointestinal tract that has been missed and it is entirely reasonable to get a second opinion. However, if that second gastroenterologist agrees with the first, then now is the time to let go of the belief that all of those scans, scopes and specialists have missed something. It’s more likely that the problem is not your gastrointestinal tract. 
  2. It is possible that your symptoms are a manifestation of early disease that is not detectable in its current state. This happens all the time. If you present with a scratchy throat, and there is nothing to see on examination (or an MRI), then it may be impossible to provide a definitive diagnosis at that point in time. No amount of specialists or tests will help.However, when you return in a few days with a sore throat, runny nose and cough we can now confidently announce that your itchy throat was the beginning of an infection. In these situations it is your change over time that secures the diagnosis. For this reason, you should not assume that because doctors couldn’t find a physical cause previously that they won’t in the future. Instead, watch for new symptoms. They could be the clue to your diagnosis. Write them down including dates, times and what’s going on at the time. Discuss them with your doctor. 

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