Constipation, Dr Joe Gulati, Dr. Ayman Quigley discussed on Your Health First with Dr. Galati
Go to Dr Joe Gulati dot com for More information about what we have, and we will be talking about. I hope you enjoyed Michael Garfield. The last segment. He is always full of energy and never know what he's going to say. All righty. Well, as I had said earlier. The next person, Dr. Ayman Quigley has been on the programme and he is one of the few people that was patient enough to die Elin during the years he lived in Ireland in the middle of the night, calling into Your health first, But let me just give you a little background on Dr quickly before we get him on. He isn't currently The David M. Underwood, chair of medicine and Digestive Disorders Department medicine professor of medicine. At Houston Methodist Hospital. He is the past president of the American College of Guest or no guest room, neurology and the world gastroenterology. Organization former editor of the American Journal of Gastroenterology. Former Dean Medical School in Cork, Ireland. Author researcher. And All around. Awesome physician. Dr Quigley, Welcome again to your health first. How are you? Very well. Thank you. Great to be with you again, Joe. Maybe a year or two since we were together, But we've we've done this many times before. In a ball. George? Yes, yes. And I and I, and I believe that the one thing you and I both share outside of patient care is education. And this is this is the crux of the programme here now. In all of the Possible topics that I could ask you to talk about constipation. Is the one tonight so Well, This is a no bars topic for this program, so I guess before we really dive into it. A lot of people say I'm constipated, but there may not be constipated. So really, what would you say is your definition of what constipation is for everybody listening tonight? First of all. I applaud you, Joe for breaking this topic up because I think it's one that's unfortunate he gets doesn't get the other time it showed because it really is very distressing from for many, many people. I think you bring up a very important point in that's the definition of constipation. Constipation means many different things to many people, and more things we have positions fails to appreciate is that it does mean different things. For many years. We were fixed to this kind of Victorian concept. The constipation men's That you didn't have a bomb would want every day or every second day way. No, no, that that's actually on the minority of the problem of constipation. For many people, constipation symptom means that they had difficulty having abound open tonight. In the essence of the problem. They have to strain They feel it's not complete. They have to try and try again or some people very distressed. They get the arch to go on. They just can't do anything and that's very distressing for people and can lead to a lot of problems. So I think would be I'm a lot more flexible in understanding of constipation, and even the guidelines on the base. Bodies that come up with these technicians know, acknowledge that we have to be a lot more. Broad, if you like, in our concept of constipation and brought in a way that truly understands, or patients herself in problem. Well, you know that approach, which I fully endorse, requires two things. One is listening on the part of the physician or having a A set of probing questions to clarify it and many times the patients when when we do ask them about how often or how much straining or what symptoms. They almost seem a little caught off guard to say, Well, you know, if I had known this question ahead of time, I would have prepared for you a little bit better. What do you think of that? That on the physician side, we're not asking the right questions or spending the time and patients aren't quite Able to describe what really is happening, Probably because they're embarrassed. What were you actually hit on two of the most important issues in this whole area on the first, Unfortunately, where we've let people down on that is not listening. And I wanted things I tell our students and our training is all the time. They say. Also source constipated assaults of diarrhea, I think. Well, what exactly does that mean? And they look at me that I got two heads because that actually is the essence of the problem. Right. And I think when you have a patient sitting with you whether your primary care, doctor or specialist and this guy got constipation, you must fully understand exactly what the patient means by that before they leave the the consulting room. If you haven't done that it actually failed a patient because you're likely To make decisions on their behalf, which may actually take them and completely the wrong direction. And you also like to prescribe things for them, which may be totally useless. So I think that's the first part of your quest. The other part actually is very important. I think we should be more proactive in terms of top looking after patients and that another was teeing up some of these issues, perhaps by questionnaires ahead of time drops by, you know, today's pieces of a patient education before had to So that they can think about things about what exactly happens when I try to have about books, Right? Right. Do I have to strain? How long? How long am I sitting there kind of a bomb movement is painful. Do I feel that it's completely have to try again. Those are questions which you know, because the that I private interest in. We asked routinely, but I think it doesn't take very long. Actually, I think you can make fatal errors on the pavement on work, but I think you make serious errors. In terms of assessment without me, if you don't have those questions. Well, you know, the one the sort of that the sister set the questions here. Which is, I think part of this whole discussion here. Is for patients to describe for me or for you what their stool looks like. And there again, there are some patients that literally will come with a sketchbook. Of the stool and others are flabbergasted that we're asking, And they will say will excuse me. I just am not a looker. And I have to say Look, start looking, because that may help out what do you say to the people that are not Looking But we actually know in our my consulting rooms when we were seeing patients who have a little chart in each of the rooms is called the Crystals to scale. Yes, on bits, of course, is a city in England and the reason for the true scale of many years ago. I'm connection off standing condition, gastroenterologist and chemical researcher had developed the Bristol stool scale whereby they have little pictures. You know, cause only diarrhea to the hardest of hearts Tool and Dick. Score them and you can look at it. And in fact, one of the things I found Amazing, Recep. You know this charges up in in our examination rooms before it went through the patient's A well I'm a 35. And you're already you're off to a great start. Yes, because 11 thing that has been discovered is that that crystals to game Actually, Carl. It's very well with the function of the column that I think that's been a major, very simple, very completely Patients orientated device, but it's actually very helpful, and I think it's it's the ultimate ice breaker in a sense to say OK, instead of getting graphic with everything, just 0.1 through five. Tell me where you're at here. And it gets down now, when? When you look at the statistics, you know everybody from the beach to the various medical societies say about 2.5 million people suffer constipation. I would almost think that you could almost double that number..