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When Simple Gastrointestinal Problems Warn of Serious Health Problems

Gastrointestinal Problems

How trusting the medical team at Samitivej helped a patient overcome his fear and receive necessary treatment.

Samuth Nuchnart, came in for a consultation with Dr. Pitulak Aswakul because he was experiencing tightness in the chest and bloating in the stomach. The doctor recommended that he undergo both gastroscopy and colonoscopy, but due to his being 80 years old and never having undergone anything like that he told them he didn’t want to do it since he was afraid of what might happen. She therefore recommended alternative treatment in the form of medication aimed at treating his symptoms for one week which, while it helped a little, did not completely relieve him of his problems. The doctor was then able to convince him to carry out the procedures. At first it all looked so easy but nothing in life is that simple…

because he had a history of heart disease. The patient was taking anticoagulant medication, so he had to stop taking those drugs for one week before the procedure and attend consultations with a cardiologist while doing so. He was cleared to undergo the gastroscopy and colonoscopy, during which a small polyp was detected. The doctor removed the polyp and sent the biopsy sample for testing. The results came back negative for cancer, which was extremely relieving for everyone involved.

However, that is not the end of the story. A 3-centimeter polyp in the colon also displayed itself in his duodenum which could have required a “Whipple procedure” if it were to be removed. That is a serious operation for anyone—let alone an 80-year-old man—due to the high rate (1 in 4) of death caused by the surgery, the position of the polyp, the chance of colon perforation and the likelihood that surgeons would be unable to fully remove the polyp. After detailed conversations to discuss suitable treatment options, it was decided that laparoscopic surgery would be the best choice. After surgery, the doctors gave him the all-clear which, once again, was a terrific relief for all involved.

Samuth Nuchnart said, “I suffer from heart disease and underwent a quadruple bypass operation in 2002. By the beginning of 2014 I began to feel a tightness and bloating in my chest, but I couldn’t easily tell the symptoms apart. I was also having trouble sleeping due to anxiety about my heart health, so I decided to come and see Dr. Pituluk. She suggested an endoscopy, which I initially refused because I was afraid of the procedure. However, I eventually agreed after the doctor carefully explained the risks to me. She also comforted me and I began to understand just how talented she was, as was the whole medical team, including the anesthetist, Dr. Usanee. They gained my full trust as they helped me with my initial procedure, while the surgeon involved also assured me that he would remain by my side throughout the operation, and check how I was the whole time. I felt comfortable and was more than happy to put my life in the hands of the medical team.”

Samuth Nuchnart went on to say that, “In the end, everything turned out well, with my bloating and chest tightness all but disappearing. I have been so impressed with the doctors and medical staff who provided such careful treatment and explained what they were doing every step of the way so that I fully understood how and why they proceeded. If medical staff do not properly explain what is going on, I think their patients would feel extremely anxious. If any of you suspect that you are suffering from a health disorder, I would advise seeking treatment at the earliest opportunity, not leaving it for six or seven months like I did. I wrongly believed that my heart was the problem. I should have seen an expert sooner, but unfortunately I didn’t fully understand how a doctor could help me with my problem. Just think, I’m 80 years old and if I can have an endoscopy without any problems, what does a 50-year-old have to be afraid of?”

In addition to the words of Mr. Nuchnart, Pitulak Aswakul, M.D. (Specialist in Liver and GI Disorders at Samitivej Sukhumvit Hospital) would like to offer the following advice: “Carrying out a colonoscopy, even if there are no outward symptoms, can ensure that any irregularities, such as polyps, are detected as early as possible. This allows for rapid removal before they can develop into cancer. There is no reason at all to fear such a procedure. Doctors might also be a source of anxiety for patients. Here at Samitivej we work as a team, carefully planning treatments that are tailor-made for our patients’ needs. Mr. Nuchnart was able to make a full recovery because of the trust he placed in our medical team. The result of this trust was a smooth and efficient treatment that was extremely satisfactory to all involved.”

In addition to the words of Mr. Nuchnart, Pitulak Aswakul, M.D. (specialist in liver and GI disorders at Samitivej Sukhumvit Hospital) would like to offer the following advice: “Carrying out a colonoscopy despite no outward symptoms could ensure that any irregularities, such as polyps, are detected at the outset, allowing for rapid removal before they can develop into cancer, meaning there is no reason at all to fear such a procedure. Doctors can also be a source of anxiety for patients, but here we work as a team, carefully planning treatment that is tailor-made for our patients’ needs, just as in the case of Mr. Nuchnart who was able to make a full recovery because of the trust he placed in our medical team. The result of such trust was smooth and efficient treatment that was extremely satisfactory to all involved.”

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Pitulak Aswakul, M.D. Summary:

Internal Medicine

Internal Medicine