Do I need to see the doctor?
It is not always easy to decide when to seek medical help and when to just wait
and see.
In an emergency, your local hospital A&E department is the quickest route to
medical help. Such emergencies would include a bleeding or perforated ulcer and
bleeding or choking associated with regurgitation.
Such dramatic events are rare compared with less serious problems which only require
an explanation. Most practices will have a doctor on call, alternatively the NHS
runs a 24-hour help line (NHS Direct: 0845 4647). Many problems can be solved with
a telephone call, the person you speak to will be able to decide whether you need
medical attention and how urgently.
In the daytime, you can speak to a qualified pharmacist. They understand medical
conditions as well as treatments you may be taking. They will know when a doctor’s
help is needed. Alternatively there may be practice nurses and other health professionals
whose help could be more useful.
When you see your doctor, it helps both of you if beforehand you have thought through
a few important points relating to your problem e.g. frequency of indigestion, days
off work etc. This helps you focus on the consultation and lead to an optimal outcome.
There are many reasons why you might be asked to see a hospital specialist.You may
need a hospital appointment for a check-up or a particular procedure that cannot
be carried out at your GP’s surgery. A hospital appointment is not necessarily a
sign that your condition is serious. However, your doctor may have cause for concern
if you complain of any of the following:
- Unintentional weight loss of more than 3kg (about half a stone)
- Loss of appetite
- Persistent vomiting
- Worsening symptoms, especially if you have a previous history
of a stomach ulcer or stomach operation
- Black, sticky, tar-like stools
- Food sticking or pain on swallowing
Surgery for acid-related disorders is less common since the discovery of acid-suppressing
drugs. Most surgery can now be carried out either through an endoscope (flexible
tube passed into the gullet and stomach) or using a laparoscope (‘keyhole’ surgery).
In order to prevent severe or persistent reflux oesophagitis, the commonest type
of operation is called a Nissen fundoplication, where the section of the oesophagus
near the stomach is telescoped in on itself. This makes the oesophageal wall thicker,
consequently improving its function as a valve, thereby preventing the acid reflux.
Reasons for other types of surgery are to repair damage, e.g. a perforated ulcer,
or to remove diseased or abnormal tissue.