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Which gastrointestinal symptoms does your doctor need to know about?

The gastrointestinal (GI) tract includes your esophagus, stomach, small intestine, colon (or large intestine) and rectum. When it’s functioning smoothly, you may not give it a second thought. But when there’s a glitch in the system, some GI issues can get your attention pretty quickly. Other GI symptoms may be more subtle. It can be hard to know which things to report to your doctor.

For Dr. Talia Zenlea, a gastroenterologist at Women’s College Hospital, too much information is better than too little.

“My general approach as a physician is that I would rather know than not know,” she says. “So the first thing I tell people is, if you’re concerned about a gastrointestinal issue, talk to your doctor about it.”

Symptoms to report

There are some GI symptoms that definitely warrant a mention. Dr. Zenlea recommends telling your doctor about any rectal bleeding (or blood in the stool), any pain, or a change in bowel habits.

“A change would be anything that’s not normal, and doesn’t go back to normal. It’s okay to have a slight variation from day to day, or maybe you went out and ate something different and it didn’t agree with you – that’s okay. But if it’s a sustained change over time, then we certainly want to know about it,” she says.

“If there is any blood, we always want to know about it. Again, it doesn’t mean there’s something catastrophic going on, but I'd always want to know so I can figure out if we need to take further steps. Abdominal pain is also something worth noting – again it won't always require a work-up, but warrants a mention.”

If you’re experiencing symptoms related to certain types of foods, it’s a good idea to let your doctor know.

“Certain dietary intolerances can be indicative of an underlying problem,” Dr. Zenlea explains. “For example if suddenly you’re unable to tolerate any gluten, it could be indicative of celiac, which is an autoimmune condition that impacts the small bowel and warrants GI investigation and followup. It wouldn’t necessarily mean you have celiac, but it’s worth telling your doctor about.”

Often, GI symptoms turn out to be nothing to worry about.

“That’s my favourite kind of visit with a patient: when I can offer reassurance,” says Dr. Zenlea, whose BellyBlog.ca website offers GI and health information from medical experts.

"But sometimes symptoms can be indicative of a problem that we’re not seeing. For example inflammatory bowel diseases like Crohn’s or ulcerative colitis can present with fairly dramatic diarrhea, or abdominal pain that doesn’t go away, or rectal bleeding. It doesn’t necessarily mean you have those conditions if you have those symptoms, but it means we need to rule them out.”

The same principle applies to colon cancer.

“We tell people to look out for things like a sudden change in their bowel habits that doesn’t go back to normal – like they suddenly can’t pass stool, or they’re passing a lot of blood in the stool – those symptoms can sometimes be indicative of colon cancer. It doesn’t mean that they always are, but we’d want to investigate further.”

Don’t be shy

Sometimes people are hesitant to discuss GI symptoms because they find topics like incontinence of stool or rectal bleeding awkward. But Dr. Zenlea stresses that there is absolutely no need to feel uncomfortable, and the sooner that conversation happens, the sooner someone can get treatment and address those symptoms.

“It’s not an awkward topic for us. As gastroenterologists this is what we do all day. This is what we talk about, this is what we ask about. Don’t be uncomfortable mentioning it to your GP because they’re also used to dealing with these questions and talking about these topics,” Dr. Zenlea says, adding that whatever symptoms you’re experiencing, your doctor has seen them before.

“You’re not alone, and it’s not the first time we’re hearing someone talk about these things. And we definitely want to know about them because we don’t want it to lead to a delay in being able to treat you and hopefully get you feeling better.” 

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: August 2019.

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