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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 treatment needed.

Samuth Nuchnart came in for a consultation with Dr. Pitulak Aswakul because he was experiencing tight stomach alongside bloating. The doctor recommended that he undergo a gastroscopy and colonoscopy but, due to his advanced age (80) and having never undergone anything like that before, he decided to not have the screening as he was afraid of what might happen. The doctor therefore recommended alternative treatment in the form of medication aimed at treating his symptoms for around 1 – 2 weeks which, while they helped a little, did not completely relieve his problems. The doctor was then able to convince him to carry out the procedure. 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 on anticoagulant medication, meaning he was required to cease taking those drugs for one week before the procedure and attending consultations with a cardiologist while doing so. Once he was cleared to undergo the gastroscopy and colonoscopy, a small polyp was detected. The doctor then removed the polyp and the biopsy sample was sent for testing. Those 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, if it were to be removed, could have required a procedure called a “Whipple procedure”. That is a serious operation for anyone – let alone an 80-year-old man – due to the high rates (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 remove the polyp fully. Detailed conversations were had with him to ensure suitable treatment plans were put in place, concluding that laparoscopic surgery would be the best option. Once that was completed, the doctors gave him the all-clear which, again, was a massive relief for all involved.

Samuth Nuchnart said, “I suffer from heart disease and underwent a quadruple bypass operation in 2002, although by the beginning of 2014 I started to feel a tightness in the chest alongside bloating, but I couldn’t really tell the symptoms apart. I was having trouble sleeping too as I felt anxious about my heart health, so I decided to come and see Dr. Pituluk. She suggested an endoscopy which I refused because I was afraid of the procedure. However, I eventually agreed and the doctor carefully explained the risks to me. She also comforted me and I began to understand just how talented she was, as were 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 they would remain by my side throughout the operation, checking 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 here.”

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 that provided such careful treatment, explaining 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 6 – 7 months like I did. I falsely believed that it was my heart that was the problem. I should have seen an expert really but, unfortunately, I didn’t fully understand how the doctors could help me with my problem. But, just think, I’m 80 years old and if I can have an endoscopy without any problems whatsoever, 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 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.”

Under care of:

Pitulak Aswakul, M.D. Summary:

Internal Medicine

Internal Medicine