Which Medical Specialty Should I Consult for My Symptoms?

Which specialty clinic should I visit?

Hello, Doctor.
I am currently working in mainland China.
Three weeks ago, I had a buffet barbecue dinner with friends and experienced gastrointestinal discomfort that led to continuous diarrhea for about two days (approximately 20 times).
After resting for a day, my bowel movements returned to normal (there were four of us, and only I experienced gastrointestinal issues; we did not consume any alcoholic beverages that evening, but I did try a lot of grilled beef).
However, two days later, I began to feel pain in the left side of my chest near the area below the left clavicle and below the left nipple, along with soreness in the left shoulder.
The symptoms worsened with deep breathing.
About two days later, I woke up in the morning with throat discomfort and a cough that produced slight phlegm (the phlegm was slightly yellow) but contained dark red blood clots.
After a few more coughs, I noticed bright red streaks in my saliva, and my throat had a metallic taste of blood.
I have already visited a clinic in mainland China (with a prescription from a Taiwanese doctor), where I had a chest X-ray.
The doctor diagnosed me with acute bronchitis, and my symptoms improved after taking medication.
However, sometimes I still feel a sharp pain under my left ribcage and above my left waist for a few seconds when taking deep breaths, and my throat feels tight and constricted.
Aside from this, I have not experienced any cold symptoms.
To be cautious, I would like to undergo a thorough examination when I return to Taiwan.
Which specialty should I consult? Wishing you success in your work and all the best.

khanduras, 30~39 year old female. Ask Date: 2012/08/29

Dr. Liao Yaopan reply Family Medicine

Hello, based on the symptoms you described, for a comprehensive evaluation, it is recommended that you first consult with your family physician.
Depending on the situation, necessary referrals can be made afterward.
If time is of the essence, you may also consider arranging a comprehensive health check-up at your own expense to quickly understand your current health status and take appropriate action.
Thank you for your message, and we care about your well-being at Changhua Hospital.

Reply Date: 2012/08/29

More Info

Based on your symptoms and the sequence of events you've described, it seems that you are experiencing a complex set of issues that may involve multiple medical specialties. Here’s a breakdown of your symptoms and the appropriate medical specialties you should consider consulting:
1. Gastroenterology: Your initial symptoms of gastrointestinal distress and diarrhea following a meal suggest a possible gastrointestinal infection or foodborne illness. Since you mentioned that only you experienced these symptoms after a group meal, it would be prudent to consult a gastroenterologist. They can perform further evaluations, such as stool tests or endoscopy, to determine if there are any underlying issues related to your digestive system.

2. Pulmonology: The subsequent development of chest pain, especially when deep breathing, along with the presence of blood in your sputum, raises concerns about potential respiratory issues. A pulmonologist specializes in lung and respiratory conditions and can conduct tests such as a chest CT scan or bronchoscopy to assess for any lung infections, inflammation, or other pulmonary conditions.

3. Internal Medicine: Given the complexity of your symptoms, an internist could provide a comprehensive evaluation. They can coordinate care among various specialists and ensure that all aspects of your health are considered. An internist can also help manage any systemic issues that may be contributing to your symptoms.

4. ENT (Ear, Nose, and Throat): Since you are experiencing throat discomfort and coughing up blood-tinged sputum, it may also be beneficial to see an ENT specialist. They can examine your throat and airways for any signs of infection or other conditions that could be causing your symptoms.

5. Cardiology: Although your symptoms primarily point towards respiratory and gastrointestinal issues, if you continue to experience chest pain, especially if it worsens or is accompanied by other symptoms like shortness of breath or palpitations, a cardiologist should be consulted to rule out any cardiac conditions.

Additional Considerations:
- Follow-Up on Symptoms: Since you have already seen a doctor and received a diagnosis of acute bronchitis, it’s important to monitor your symptoms. If you notice any worsening or new symptoms, such as increased difficulty breathing, persistent chest pain, or significant changes in your sputum, seek medical attention promptly.

- Diagnostic Tests: When you return to Taiwan, request comprehensive diagnostic tests, including blood tests, imaging studies, and possibly a referral to specialists based on your ongoing symptoms.

- Communication with Healthcare Providers: Be sure to communicate all your symptoms clearly to your healthcare providers, including the timeline of when they started and any changes you notice. This information is crucial for accurate diagnosis and treatment.

In conclusion, given the multifaceted nature of your symptoms, starting with a gastroenterologist and a pulmonologist would be advisable. They can help identify the root causes of your gastrointestinal and respiratory symptoms, respectively. An internist can also be a valuable resource for coordinating your care and ensuring that all aspects of your health are addressed.

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