r/Gastroenterology

Ive been on reta for the past 10 months ive lost 60+ pounds and im looking great, recently i had discomfort on my intestines a feeling of like trapped gas for a week. After rubbing my abdomen one day i felt crazy sharp pain. Went to the ER and they told me i had perforated my small intestine, they couldnt find a reason as of why this had happened to me, i got checked for crohns and every other posible outcome and everything came up as negative, i didnt tell the doctors about my reta use since its easy to blame a non fda approved peptide. My question is could retatrutide been the reason i perforated my intestine?

My dosage was 5mg a week

Any reason the dr that did my colonoscopy and endoscopy would check my d-dimer immediately after waking up in recovery? Nothing abnormal happened during scopes with anesthesia (no slowed breathing, no low blood pressure etc.) I’m just confused. Will be calling when office opens. D-dimer did come back normal. I was able to speak with a nurse that was present in the room during my scopes. She pulled up my file and dr didn’t write anything about d-dimer in notes.

The recent ACG guideline says that test-of-cure is required in all patients after treatment. Urea breath test or fecal antigen, at least 4 weeks post-completion, PPIs held for 2 weeks prior.

As a GI doctor, I believe in this recommendation. But in my experience, test-of-cure is one of those things that falls apart at the follow-up stage. Patient might be feeling fine, symptoms might be resolved, they don't come back. Or the ordering physician assumes someone else will arrange it. Or the patient gets the test but still has PPI on board because nobody told them to stop it, and you get a false negative.

I have started giving patients a written instruction sheet at the time of prescription: Please Finish antibiotics, wait 4 weeks, stop PPI 2 weeks before the breath test, then call me.

But I am yet to find a system-level solution for this,

For the past 5 years ive been dealing with gut and bowel issues . Symptoms include :

Constipation

Abdo pain

Dihorea

Fatigue

Migraines

Leg pain

Urgency

Indegestion

Sour taste in mouth

Feeling sick

Breathlessness

Ive had alot of tests and all have come back clear apart from the endoscopy which was done around June or July last year which showed mild gastritis which I got after I had h.pylori . I took the meds for h.pylori and ive had numerous further testing for it all of which have come back negative. I took various PPI none of which worked. They either done nothing or made either the acid or my bowel issues worse . I dont think it helped they tried them one after another in a very short space of time . I also tried gaviscon advanced and rennies which done nothing. I was following a bland diet too . My symptoms went away for a bit ( the acid reflux ones) but in the past month have come back .

My official diagnosis are: IBS , GERD and fibromalgia.

Ive had ALOT of testing and things have mostly come back clear which I guess is reassuring but at the same time ive tried so so many things for my IBS and nothing works. I cant deal with it anymore . I am so symptomatic all the time and nothing works . Nothing they suggest , no amount of cutting things out .

So my question is ...what are the other possibilities other than " IBS"

Can’t find help from doctors. My surgery was a year ago and pain keeps getting worse. Pelvic floor PT is at a loss. Does anyone have any recs? I truly feel like I could die from this. It’s worse pain than pre-surgery. CTs, USs, and MRIs are all relatively normal.

Facility fee after a procedure aside from Dr’s fee, lab and pathologist. Is this legal?

I need to take my mom to a gastro doc asap. Does anyone have any recommendations in the Nashville area? She has known internal bleeding and had an endoscopy that showed nothing. She has been waiting on cat scans for almost four weeks and the nurse can’t seem to get it scheduled. My mom is 78 and all of her doctors and staff must be so overwhelmed by the areas growth. This could be the only explanation for the lack of care.

am not asking for medical advice.

curious how you detect bile duct cancer in its early stages? I’ve heard it’s usually an incidental finding but what does stage 1 or 2 show up on? anything? or does it just not show up?

I’m an anesthesiologist at a community hospital and I’m genuinely trying to understand the rationale behind something I keep seeing from a small subset of GI docs.

We recently had a critically ill patient come in for an EGD for possible GI bleed. The patient had severe pulmonary hypertension, severe aortic stenosis, and was on norepinephrine and epinephrine infusions just to maintain MAPs >60. Before the case, I spoke with the GI physician and emphasized that the patient was extremely tenuous and that if possible we should keep the procedure focused and efficient.

The procedure ended up showing no active GI bleed, but despite that, the physician proceeded to take multiple bottles of biopsies, adding another 10–15 minutes to the case.
What I find interesting is that out of roughly 10 GI physicians in the group, only 1–2 routinely take extensive biopsies on nearly every case, while the others are much more selective.

For the GI folks here: what’s the reasoning behind this practice pattern especially for a GI bleed that doesn’t have any signs of bleeding

My Gastroenterologist got me a Prescription for both of these Colonoscopy Preps. And I'm not sure if I should drink them both. This will actually be my third Colonoscopy. I'm actually afraid that I might not be able to finish all of it because I threw it up last time. What has been everyone's experience with drinking both of Liquid Solutions? If I could get some advice and support. I would really appreciate it. The last thing that I want to do is reschedule my Colonoscopy. What has been everyone's experience with getting a Colonoscopy done? It's been years since I've had one done. I'm just hoping that I can drink The Prep Solutions without any problems at all. I remember one of Colonoscopy Prep Solutions tasked like warm rotten milk. And I don't want to go through anything like that ever again it was awful.

I’m in South Florida looking for private GI jobs around Broward County and see a lot of opening for gastrohealth. I will be speaking to one of their recruiters soon. I was wondering if anyone has any experience working for them and how your experience has been?

Hello, Im scheduled for my first colonoscopy + endoscopy in search for source of my anemia (bleeding). Nurse ordered the Suprep liquid bowel prep but after seeing husband so miserable chugging it down and his brother saying the sutab tablet prep was a breeze, i messaged asking to switch to tablets.

Nurse replies: -If you're having both a colonoscopy and an endoscopy, Sutab is not recommended because it may cause irritation seen during the endoscopy.

Have you also been given this advice?

Has anyone done both liquid prep and tablet prep and have a better experience with the tablets for their colonoscopy prep?

thank you!

Hi all - exploring a job with United Digestive. Competitive salary off the bat, then transition to partner where salary is combined off of: % of production, ASC profit, Ancillary revenue. They are selling a pretty sweet financial picture. I've been told to be weary of PE so curious if there is anyone with actual insight.

Created a burner account just in case. Location is SE USA.

Hi fellow gastroenterologists ❤️ Second year gastroenterology fellow here. Is there anyone having left hand numbness problem in prolonged cases and if so how did you solve this problem. It’s really distressing me since I learned basic endoscopy and colonoscopy, soon I will start to learn complex procedures. Thanks in advance.

Yesterday I started taking the bowel prep medication before my colonoscopy. The first dose went completely fine — I felt okay and finished the cleansing process without any problems.

In the morning I had to take the second dose, but this time I started feeling nauseous and had strong gagging/vomiting urges. After about 20–30 minutes, I suddenly vomited blood. I went to the emergency room immediately. They did a gastric lavage, and there was a LOT of blood. Honestly, it was terrifying.

They ran blood tests, an ultrasound, X-rays, and then an endoscopy).That’s when they told me I had Mallory-Weiss syndrome with two small tears, each about 5x5 mm.

They prescribed treatment and sent me home, and that’s basically the whole story. That’s weird, but I feel completely fine, no nausea or pain. Nothing

Has anyone else experienced something like this? I’m honestly still really shaken and scared.

This started couple months ago off and on but for the last 3 months I have had diarrhea everyday and now bleeding everyday. I guess I would describe the sensation as a cat really empty my stools completely but now I feel so discomfort on my butt.

I have an appointment to see a GI specialist in a week I just want this to stop

Anyone expecting this or has?

Only difference I can think of is that is that I got an IUD 8 months ago

I went through the discussions that happened in DDW 2026 in Chicago. And the highlight that I loved the most is that -> EUS is no longer an advanced skill. It's becoming the baseline.

It wasn't in just one session. It was every session.

The other thing that struck me the most was that - the economics track was unusually direct. Demonstrating EUS value to payers (diagnostic yield, downstream decision impact, procedure pairing efficiency) is now being framed as a survival skill for GI programs, not an administrative afterthought.

There was also strong signal on ESG finally being positioned less as "bariatric lite" and more as a legitimate first intervention in appropriate obesity patients, with 18-24 month weight loss data.

And quietly, the target trial emulation data on early ERCP in elderly choledocholithiasis. The reflex to scope everyone urgently is being challenged with actual numbers now.

A lot came out of DDW. But if you can only act on one thing right now is that if your the GI program doesn't have a structured EUS training, you're already behind.

As a GI practitioner, are you communicating this in your clinics/labs??

Starting GI fellowship soon and trying to prepare efficiently before July. Would love advice from current GI fellows/attendings:

#What books/resources were actually worth buying?
Best sources for:
General GI
Hepatology
Endoscopy basics
Boards

#Any courses/bootcamps/videos you strongly recommend before starting?

#Conferences that are most valuable for fellows (DDW, ACG, AASLD, ACG/ASGE courses, etc.)?

#Things you wish you had learned BEFORE fellowship started?