Which Specialist Should I See for My Ongoing Health Issues?

Which specialty should I see?

Hello Doctor: On New Year's Eve, I had hot pot with my family, but about an hour later, I started experiencing stomach pain and diarrhea, which was so severe that I felt weak and had chills in my back.
However, my family members were fine.
I took some antacids on my own, but I still felt some lingering pain.
On the first day of the new year, I had mild pain, but it wasn't enough to cause diarrhea, and I felt like I was gradually improving.
Since I stayed up all night on New Year's Eve, I wonder if that contributed to me catching a cold, as my throat started to hurt when swallowing saliva, and I had nasal congestion.
Additionally, my menstrual period started (I seem to catch colds before my period every time).
I just rested and slept more, but since the clinic was closed during the holiday, I didn't see a doctor until the fourth day of the new year.
The doctor diagnosed me with acute sinusitis and advised me to take my medication on time, or else surgery would be necessary.
Now that I've finished my medication, I feel better from the cold, although I still have a bit of nasal congestion.
However, I noticed a little blood when I picked my nose, even though I wasn't using much force, and sometimes I feel a vague pain and numbness in the sinus area.
Additionally, I have pain in my back and neck (without any trauma), and I don't know the cause.
May I ask: 1.
Which specialist should I see? 2.
Why do I catch a cold every time my period comes? 3.
How can I improve my chronic nasal congestion? (I previously asked a doctor, and they said it was allergic rhinitis.)

Qing nin bang wo jie da, gan xie nin!, 20~29 year old female. Ask Date: 2006/02/09

Dr. Xu Li'an reply Family Medicine

Dear Banana0727,
Based on your description, it seems that the symptoms of acute gastroenteritis and cold appearing consecutively could likely be what is referred to as a gastrointestinal cold, meaning that symptoms of both a cold and gastroenteritis are present simultaneously.
Since you mentioned having blood in your nasal discharge, please visit an otolaryngology clinic for follow-up examination.
It is not the case that you catch a cold every time your menstrual cycle occurs; it may just be a coincidence.
You could keep a record of the dates you catch a cold each year along with your menstrual dates.
I often use the example that ice cream sales increase in the summer, and so do drowning incidents; this does not mean that eating more ice cream leads to a higher risk of drowning.
Chronic nasal congestion and runny nose may be due to allergic rhinitis.
Some people say that exercise, such as swimming, can improve physical condition, while others suggest that immigrating to a country with a better environment can reduce pollution, which in turn may increase the types and quantities of allergens in the air.
Thus, the proportion of allergic individuals in Taiwan is increasing year by year.
Even I, as a doctor, cannot cure my own allergic rhinitis; what do you suggest I do?
It’s similar to when patients ask me about the effectiveness of laser surgery for myopia.
My response is to ask their ophthalmologist whether they themselves have undergone laser surgery.
If even the ophthalmologists are hesitant to undergo a procedure they are recommending to patients, while emphasizing its safety, isn’t that strange?
Wishing you a speedy recovery and peace of mind.
Sincerely,
Hsu Li-An
Family Medicine Department, Hualien Hospital

Reply Date: 2006/02/09

More Info

Based on the symptoms and concerns you've described, it sounds like you are dealing with a combination of gastrointestinal issues, respiratory problems, and possibly some musculoskeletal discomfort. Here’s a breakdown of your questions and some recommendations on how to proceed.

1. Which Specialist Should I See?
Given your symptoms, it would be advisable to see a few different specialists. For your ongoing nasal and sinus issues, an Ear, Nose, and Throat (ENT) specialist would be the most appropriate choice. They can evaluate your sinus condition, especially since you mentioned having acute sinusitis and ongoing nasal bleeding. If the bleeding persists or worsens, or if you experience significant pain, they may perform further diagnostic tests or imaging to assess your sinuses.

For your gastrointestinal symptoms, such as the abdominal pain and diarrhea, a Gastroenterologist would be suitable. They can help determine if there is an underlying condition, such as food intolerance or infection, that needs to be addressed.
Lastly, for the back and neck pain, you might consider seeing a Primary Care Physician (PCP) or a Physical Therapist. They can evaluate your musculoskeletal health and provide recommendations for treatment, which may include physical therapy, exercises, or other interventions.

2. Why Do I Get Sick Every Time My Menstrual Cycle Starts?
It’s not uncommon for women to experience an increase in susceptibility to infections or illnesses around their menstrual cycle. This can be attributed to hormonal fluctuations that occur during your cycle. For instance, the drop in estrogen and progesterone before menstruation can impact your immune system, making you more vulnerable to infections like colds or sinusitis. Additionally, if you experience premenstrual syndrome (PMS), symptoms like fatigue and stress can further weaken your immune response.

3. How Can I Improve My Chronic Nasal Congestion?
Chronic nasal congestion, especially if diagnosed as allergic rhinitis, can be managed through several strategies:
- Allergy Management: If you have allergies, identifying and avoiding triggers is crucial. Consider consulting an allergist for testing and management options, which may include antihistamines or nasal corticosteroids.

- Saline Nasal Irrigation: Using a saline solution to rinse your nasal passages can help clear out mucus and allergens, providing relief from congestion.

- Humidifiers: Keeping the air moist can help alleviate nasal congestion, especially in dry environments.

- Over-the-Counter Medications: Decongestants can provide temporary relief, but they should be used cautiously and not for extended periods.

In summary, it’s essential to address each of your symptoms with the appropriate specialist. Start with an ENT for your nasal issues, a gastroenterologist for your gastrointestinal symptoms, and consult your primary care physician for your musculoskeletal pain. Additionally, managing your menstrual-related symptoms may require a holistic approach, including lifestyle changes and possibly hormonal therapy, depending on your specific situation.
Remember to keep track of your symptoms and any changes you notice, as this information will be valuable for your healthcare providers in diagnosing and treating your conditions effectively.

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