Which Specialist to See for Simultaneous Gastrointestinal and Pain Issues?

When multiple conditions occur simultaneously, it's unclear which specialty to consult?

Hello, doctor: I have a history of constipation, but I usually have a bowel movement at least once a week.
Recently, I underwent surgery for poorly differentiated uterine cancer, and I'm not sure if the heavy bleeding from exertion is causing me to avoid straining, which has led to more than a week without a bowel movement.
I feel like my stomach is still digesting food, and my abdomen is very bloated.
After a few days, I experience pain in the lower right back.
I followed up with my gynecologist, who confirmed that the bleeding from the surgical site is not a concern.
I also visited a gastroenterologist, who ordered blood tests and stool samples for further examination.
However, I'm worried about the pain in my lower right back and want to understand what's going on as soon as possible.
The gastroenterology follow-up is next week, and I’m concerned about delaying the evaluation of my back pain.
I'm unsure which specialist I should see for this issue.
Could you please help me with this? Thank you.

Xiao Q, 40~49 year old female. Ask Date: 2022/11/09

Dr. Liao Yaopan reply Family Medicine

Hello, if you are experiencing persistent discomfort, it is recommended that you return for a follow-up consultation with your physician to assess whether there are any underlying issues.
Do not wait until your scheduled appointment to seek medical attention.
Online consultations are not equivalent to in-person visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about your well-being.

Reply Date: 2022/11/09

More Info

When dealing with simultaneous gastrointestinal issues and pain, particularly in the context of recent surgery, it is essential to approach the situation with a comprehensive understanding of the potential underlying causes. Given your history of constipation and recent surgery for uterine issues, it is understandable that you are experiencing discomfort and are concerned about the pain in your right lower back.

Firstly, it is crucial to recognize that abdominal pain can often be related to multiple systems, including the gastrointestinal tract, urinary system, and even musculoskeletal structures. The pain you are experiencing in your right lower back could be referred pain from gastrointestinal issues or could indicate a problem with the kidneys or urinary tract, especially if it is accompanied by symptoms like changes in urination or any signs of infection.

In your case, since you have already consulted with both a gynecologist and a gastroenterologist, it would be prudent to continue following up with the gastroenterologist for your gastrointestinal symptoms. They can provide further evaluation of your constipation and any potential gastrointestinal complications that may arise from your surgery. The tests they have ordered, including blood tests and stool collection, are essential to rule out any underlying conditions such as infections, inflammation, or other gastrointestinal disorders.

However, given your right lower back pain, it may also be beneficial to consult with a urologist. This specialist can evaluate whether there are any issues related to the kidneys or urinary tract that could be contributing to your pain. Conditions such as kidney stones, urinary tract infections, or even referred pain from gastrointestinal issues can manifest as back pain, particularly in the lower regions.

If you are experiencing significant discomfort or if the pain worsens, it may be advisable to seek immediate medical attention, such as visiting an urgent care facility or the emergency department. They can perform a more comprehensive evaluation, including imaging studies like an ultrasound or CT scan, to assess for any acute issues that need to be addressed promptly.

In summary, while it is essential to continue your follow-up with the gastroenterologist for your gastrointestinal concerns, do not hesitate to seek an evaluation from a urologist for your right lower back pain. This dual approach will help ensure that all potential causes of your symptoms are thoroughly investigated and managed appropriately. Additionally, maintaining open communication with your healthcare providers about all your symptoms and concerns will facilitate a more accurate diagnosis and effective treatment plan.

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