Health & Support

Okay, so to make a long story short I have been seeing a GI specialist since December.  He has concluded that I have IBS-C and his treatment is fiber supplements.  I tried it but for whatever reason I could not adjust to taking the fiber powder.  I already get plenty of fiber in my diet but the man just does not believe me.  I told him that I eat really healthy and keep track of everything and he just said it is impossible and basically yelled at me for the duration of the appointment.  I again tried to bring up other important points and he just brushed it off or tuned me out because all he could keep on saying was that I couldn't possibly get enough fiber and without enough fiber I will never get better and it is my own fault.  Am I the one being unreasonable or is it him?  I feel like he is being closed minded but I also am a bit more sensitive at the moment.    I mean for goodness sakes I could eat 2 GNU bars a day and be nearly to daily 30 grams of fiber.  Should I put up with him and give him another chance to prove him wrong (maybe bring in boxes as proof) or just see if I can see another dr in the same clinic?  He is supposed to be a very good  doctor and very knowledgeable so it is me or is it him?         &nb sp;               &nb sp;

Even if your doctor is knowledgeable it doesn't sound like you've exactly 'hit it off'.   Or he could just have been having a bad day. It happens.  It may help to see another doctor in the same clinic.  Before you do, however, keep a very accurate food diary logging everything you eat and drink.  This will be useful for the next doctor who will be able to see if you're getting enough fibre.  It's always possible you may need more than 30g a day.

Too much fiber can cause constipation if you're not drinking enough.

If your doc wouldn't discuss other possible contributing factors, it's time to look for another doctor. Have you had a biopsy to make sure your colon tissue is healthy?

Next time you see him, take your fiber intake info with you. Print out a spreadsheet with date, grams fiber, grams fat, etc to show him that you're serious about eating well. Good luck!

Question--does the doctor seem to listen to you usually?  I agree with Jane, Doctors can have bad days/weeks/months and it may be helpful to see another doctor. When doctors suspect the patient is lying to themselves they get pretty stubborn.

I've had a case where the doctor knew me too well to believe I was depressed. Overall he was/is an excellent doctor, I've just had to learn his blind spots and work toward my health and go around him if necessary.

I think its you thats being unreasonable.  I also have been to a GI specialist that diagnosed me IBS after a coloscopy.  He recommended extra fiber and I explained that I eat twice the recommended amount of fiber.  He explained that there are different types of fiber and I most likely still need the supplements, reglardless of how much I get through food.  He asked me to try it for a week or two to see if its helped.  And it did - ALOT!!  I take the capsules, not the powder and it really, really helps.  I eat about 60 grams of foiber a day through food, which is really really high.  And i've always drank about 8-10 bottle sof water a day.  It wasn't until I started taking the supplements that my issues were alleviated.  And I also found that when I went away to my parents for the weekend and forgot to bring them with me the problems returned even though I was eating the same exact foods.

I did do a food diary and brought it with me but he just blew me off.  The thing that I tried to explain to him is that I felt better when I had very little fiber.  I ate crappy for like years and I very rarely would have these flare ups and they have been much worse since then.  I also drink plenty of water and I have read about the different types of fiber and I can't do the powder because it makes me so bloated that I can't eat.  That was the other issue I attempted to tell him is that I have been so sick lately that I can't hardly eat and I got down to 105 pounds because of that. 

I haven't had a biopsy or anything other than a stool sample that came back normal. 

The doc really tries to streamline his appts so you get like 5 words out before he makes his comments and from then on you don't get a chance to say much. 

I also forgot the powder one week when we went away and my inlaws ate half of my healthy food and I felt great (other than the day I had dairy). 

I have IBS as well, in addition to Ulcerative Colitis that is in remission, thankfully.

My GI doc as well told me to take fiber.  It is reasonable.

Here's my question to you - I know you've kept a food journal, but have you kept track of your bathroom trips?  Are you having diarrhea some days and then not going to the bathroom other days at all or having very hard stools?  How many times per day are you in the bathroom?

Yogurt is another tool to aid in your digestion.

He may be right and another doctor may tell you the same thing. However, I think you should get another doctor. You need one who will listen to you and communicate with you. It sounds like he has one answer and is not willing to listen to other possibiliities or even explain why his one answer is always correct.

Find someone who will listen to you, work with you, and explain things to you.

I agree with vwilki01, find a doctor that will work with you.  It's sad that so many doctors these days don't have enough time to build a rapport with thier patients or lack that ability.

On another note, did you increase your fibre intake quickly?  Sometimes you system just needs to adjust to the higher intake.  And definately increase water intake with your fibre.

As we all know, doctors have very specialized training and lots of education, and if your doctor has a great reputation, then you know he has gotten results -- BUT, doctors are people too, with the same personality traits and quirks that all the rest of us have - regardless of a doctor's skill/knowledge/experience level, you need to consult with a doctor you feel comfortable with, have a good rapport with, and can trust.  In order for a doctor to be a good fit FOR YOU, both sides of the coin need to be shiny. 

My advice:  If you don't 100% trust what your doctor is telling you, find a doctor you do trust (even if s/he is in a different specialty) to talk to.  Obviously, you're not going to follow a doctor's advice absolutely perfectly unless you absolutely trust the advice you're getting, so it will be better for your health (and maybe even better for your doctor-patient relationship) to validate your doctor's recommendations with another trusted medical professional.

I adjusted my fiber slowly and always drink plenty of water.  I promise you there is just something about that powder.  I got sick every single day that I used it and that was only about 2-4 grams in the amount that I managed to take.  I started feeling better for about a month or two and it suddenly came back with a vengeance and I haven't changed my diet at all other than a little more fiber and I have been drinking more water to offset that.  ( I was not taking the powder during those good months)

It is not that I don't trust him as a doctor but I feel like he is being very closed minded and is only seeing/hearing what he wants.  I also think that he just has opinion and he is unwilling to look into the new research and ideas.  I am going to attempt to start mixing more fiber in with my foods but I just can't drink it.  I have tried the new chewable chocolate and caramel fiber chews but they are pretty nasty and not worth the calories and you can get more fiber from more wholesome foods. 

I think I will also switch to another doctor....especially if a higher fiber intake doesn't work. 

While I still think that getting an opinion from a different doctor is a good idea, I'd like to say something in his defense. I meet a lot of obese people in my line of work. You would be amazed how many of them walk in with a bag of McDonald's, then explain to me how they are eating healthy to loose weight because they got the chicken sandwhich instead of the Big Mac. Or they tell me how there is something wrong with them because they can never sleep, then they drink and entire 2 liter of Mountain Dew in the hour before bed. (Forget the caffeine and sugar, I'd spend the night in the bathroom!) Even my husband tells his doctor about the huge amounts of fiber he eats-Which in reality amounts to some wheat bread and the powder I can slip into his food without his knowledge. My point is, I'm sure your doc has heard the same line from everyone, you just happen to be in the rare minority that actually logs what you eat so you KNOW you are eating fiber, vs those who just believe they must be eating a lot.