Post-Surgery Complications: When to See a Gastroenterologist or Immunologist?

Please specify the medical specialty and medication you would like to inquire about?

Two months ago, I underwent electrosurgical treatment for colon swelling, measuring 8 cm.
The postoperative recovery was normal; however, one month after the surgery, I experienced intestinal damage due to lifting heavy objects at work, resulting in blood spots, minor bleeding, and mucosal shedding.
I returned to the hospital for antibiotic treatment and X-ray examination.
Currently, I am taking traditional Chinese medicine for recovery, but I am not regaining my health as I did immediately after discharge.
Occasionally, I experience sharp pain, and sometimes I also feel discomfort in my lower abdomen, though the frequency is low.
There are also occasional stabbing pains in my upper abdomen.
Over the past two to three days, I have experienced unexplained swelling and pain in my old wrist injury, which is currently mildly swollen.
My immune system seems to be affected; I previously had mild rheumatoid arthritis but had not experienced any flare-ups for two years until this incident.
I would like to know whether I should consult an immunologist or a gastroenterologist.
Is the inflammation caused by the postoperative injury leading to mild immune abnormalities? Are the effects of Salazopyrin enteric-coated tablets and Acetylsalicylic acid enteric-coated tablets the same, and which one is more suitable for my described issues? Are they applicable for intestinal damage? I have previously used Salazopyrin enteric-coated tablets without significant side effects.

RICKY, 40~49 year old female. Ask Date: 2023/01/17

Dr. Zeng Guosen reply Internal Medicine

It is recommended that you first consult a gastroenterologist.
If necessary, the gastroenterologist will advise whether to see a rheumatologist for further evaluation.
Please do not self-medicate.
Thank you for your question.

Reply Date: 2023/01/17

More Info

After undergoing a significant surgical procedure such as a colon resection, it is not uncommon to experience a variety of complications and symptoms that can affect your recovery and overall health. In your case, it appears that you are dealing with a combination of gastrointestinal issues and potential immune system concerns following your surgery.
Firstly, the symptoms you describe, including abdominal pain, bleeding, and mucosal shedding, are concerning and warrant further evaluation. The fact that you experienced these symptoms after lifting heavy objects suggests that you may have exacerbated your condition, potentially leading to complications such as anastomotic leaks or bowel obstruction. It is crucial to monitor these symptoms closely, as they can indicate underlying issues that may require medical intervention.

Given your history of mild rheumatoid arthritis and the recent onset of joint pain in your wrist, it is essential to consider the possibility of an immune response or inflammation that may be linked to your surgical recovery. In this context, you may benefit from consulting both a gastroenterologist and an immunologist. A gastroenterologist can assess your gastrointestinal symptoms, perform necessary imaging studies, and determine if there are any complications related to your surgery. They can also evaluate your bowel function and recommend dietary modifications or medications to alleviate your symptoms.

On the other hand, an immunologist can help you understand whether your immune system is reacting to the surgical trauma or if there is an underlying autoimmune process at play. Since you have a history of rheumatoid arthritis, it is essential to rule out any flare-ups or related conditions that could be contributing to your symptoms.

Regarding the medications you mentioned, such as Salofalk (mesalamine) and Aco (likely referring to another gastrointestinal medication), both are used to manage inflammatory bowel conditions. However, their suitability for your specific situation should be determined by your healthcare provider. Since you have previously used Salofalk without significant side effects, it may be worth discussing with your doctor whether it is appropriate for your current symptoms.
In terms of dietary recommendations, it is generally advised to follow a low-fat, easily digestible diet post-surgery to minimize gastrointestinal distress. Foods that are high in fiber may also help regulate bowel movements, but it is essential to introduce them gradually and monitor your body's response.
In summary, given your complex medical history and the symptoms you are experiencing, it is advisable to seek evaluations from both a gastroenterologist and an immunologist. They can work together to provide a comprehensive approach to your care, ensuring that both your gastrointestinal and immune health are addressed. Do not hesitate to reach out to your healthcare providers for guidance on managing your symptoms and optimizing your recovery.

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