Q. Now comes the important question of diagnosis. What is the story here?

A. The first essential point is that any person with any of the tell-tale symptoms which indicate a gastrointestinal disorder should seek medical attention. It is fruitless self-medicating, such as throwing down some antacid pills or mixture or powders in the hope that ‘it might go away’. Certainly, if there have been dietetic indiscretions — in short, plain stupidity in one’s eating habits, such as eating the kind of food that history has shown produces a tummy upset, then the penalty is usually patently obvious for anyone to see. Some self-medication for a day or so will often help, and eliminate the grotty stomach. But with ongoing symptoms, attending the doctor is advisable.

Q. What happens when the patient visits the doctor?

A. Usually the physician will take a fairly detailed medical history. He will try and elicit a sequential description of the symptoms suffered, how long they have been present, their intensity, and so forth.

Q. Does he examine the patient?

A. The physical examination follows the history taking routine. The answers to his questions will give him a clue what to seek next. He will concentrate mainly on the abdomen, for this is the spot where symptoms are worst. He will note your reaction to his feelings and proddings (or palpation as the medics say). Always give reliable answers to his queries; it is pointless giving false ones, for the only person to suffer from this is you, the patient. If there is pain with pressure, say so. Do not try and be brave, this is foolish in the business of diagnosis. Often from the history and examination the doctor will have a pretty good idea of the diagnosis.

I might add that these days most doctors will also give the other systems of the body a quick once over — such as checking blood pressure, the heart, the urine, and other systems. Occasionally other disorders may be picked up at the same time, and this is always fruitful.

Q. What comes next?

A. If the physician suspects an ulcer, he will then proceed with the next step to confirm it. Here, there are two options open.

Q. What special examinations are carried out?

A. The first is called a barium meal x-ray of the stomach and duodenum. The second is called an endoscopic examination of the same organs.


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