Merely

Account on Hold
Account on Hold
7+ Year Member
Jul 12, 2012
1,570
1,373
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
Serious question, I am interested in GI and was wondering when people see ****? For colonoscopies the intestines should be completely clean? Why are people complaining about seeing so much ****? The only time I can think is during emergency obstructions or something. Is that the only time you guys have to deal with smelly **** or is it a daily occurrence? Thanks for the insight.
 
  • Like
Reactions: rd31

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
18,349
11,303
Status
Attending Physician
Serious question, I am interested in GI and was wondering when people see ****? For colonoscopies the intestines should be completely clean? Why are people complaining about seeing so much ****? The only time I can think is during emergency obstructions or something. Is that the only time you guys have to deal with smelly **** or is it a daily occurrence? Thanks for the insight.
You're joking, right?
 
  • Like
Reactions: 235009

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
18,349
11,303
Status
Attending Physician
No lol I have absolutely no experience with this field that's why I'm asking...
I'm not in GI, but I'd estimate that ~50% of the colonoscopy reports I read include a statement like "difficult to completely evaluate entire colon due to incomplete prep".
 
OP
Merely

Merely

Account on Hold
Account on Hold
7+ Year Member
Jul 12, 2012
1,570
1,373
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
I'm not in GI, but I'd estimate that ~50% of the colonoscopy reports I read include a statement like "difficult to completely evaluate entire colon due to incomplete prep".
Oh wow, okay see this was a very helpful post, that seems pretty gross but even more importantly like a big health problem
 
2

235009

Also, don't forget that for almost every consult you're doing a rectal exam and sometimes for patients in clinic.


Sent from my iPhone using SDN mobile app
 
Jul 29, 2016
5
0
GI is not for those afraid of feces. The GI docs routinely get "colonoscopy debris" on themselves during colonoscopy. Before every colonoscopy, you do DRE. Many patients in clinic need not only DRE but sometimes very close inspection of peri-anal areas. I've heard of GI docs having patients' feces sprayed on their chest/face.
 

wjs010

7+ Year Member
Apr 4, 2012
2,089
510
Status
Medical Student
GI is not for those afraid of feces. The GI docs routinely get "colonoscopy debris" on themselves during colonoscopy. Before every colonoscopy, you do DRE. Many patients in clinic need not only DRE but sometimes very close inspection of peri-anal areas. I've heard of GI docs having patients' feces sprayed on their chest/face.
Omg that is disgusting. I hope they were wearing a mask...????...!!!!


Sent from my iPhone using SDN mobile
 
Jul 24, 2013
34
28
Status
GI is not for those afraid of feces. The GI docs routinely get "colonoscopy debris" on themselves during colonoscopy. Before every colonoscopy, you do DRE. Many patients in clinic need not only DRE but sometimes very close inspection of peri-anal areas. I've heard of GI docs having patients' feces sprayed on their chest/face.
There is more caca in this post than in a month of colonoscopies. Seriously.
 
OP
Merely

Merely

Account on Hold
Account on Hold
7+ Year Member
Jul 12, 2012
1,570
1,373
Somewhere Sunny
Status
Medical Student, Resident [Any Field]
I actually shadowed a GI doc a few days ago and it wasnt really all that disgusting. The thing that terrifies me though is that all they did was colonoscopies and endoscopies. Literally, it was like 6 hours of that then im like damn I gotta get outta here. I understand if youre making bank doing these procedures its probably fun but wtf is going to happen if reimbursements for colo goes way down? GI is going to become the least competitive specialty ever. Am I wrong/please teach me?
 
Jul 24, 2013
34
28
Status
I actually shadowed a GI doc a few days ago and it wasnt really all that disgusting. The thing that terrifies me though is that all they did was colonoscopies and endoscopies. Literally, it was like 6 hours of that then im like damn I gotta get outta here. I understand if youre making bank doing these procedures its probably fun but wtf is going to happen if reimbursements for colo goes way down? GI is going to become the least competitive specialty ever. Am I wrong/please teach me?
If reimbursement goes down, it goes down. Some colonoscopy codes just got cut by 20% and EGD reimbursement got cut a couple of years ago, so I think GI is safe for a minute. And considering how little a colonoscopy pays now compared to a decade ago, I can't see them going down much more, but reimbursement always goes down so whatever. In the end, even after the cuts, GI is always going to be in the top paying quartile. The ancillary income in GI will always make it a well paid field.

As far as the repetitiveness, I can see how 6 hours of standing there watching would get boring. It is WAY more fun doing them. No colon is the same. It's a lot of fun and satisfying removing polyps. But you have to decide if it appeals to you. No matter what field you go into, there will be repetition, so make sure you like it. I don't feel bored in GI.
 
  • Like
Reactions: Merely

tbrep

2+ Year Member
Feb 23, 2016
8
0
I can see why GI gets a bad rap regarding being scope-focused but I assume there is freedom to shape your own practice. During med school, I rotated onto clinics with a GI boss who mainly saw IBD patients. There is a LOT of cognitive work required to assess and manage these patients. He also had an esophageal disorder clinic (which was also intellectually stimulating) and he performed some pretty neat interventions (ERCP with biliary stenting, EUS-guided interventions, endoscopic treatment of Barret's ablation). Overall, it was a nice varied work life. Of course, he might not make anywhere near as much as the guy who scopes all day but he seemed pretty fulfilled.

The only thing I couldn't stand were the functional bowel presentations. Now those were tough!
 

IM2GI

5+ Year Member
Dec 5, 2013
886
747
Status
Attending Physician
I actually shadowed a GI doc a few days ago and it wasnt really all that disgusting. The thing that terrifies me though is that all they did was colonoscopies and endoscopies. Literally, it was like 6 hours of that then im like damn I gotta get outta here. I understand if youre making bank doing these procedures its probably fun but wtf is going to happen if reimbursements for colo goes way down? GI is going to become the least competitive specialty ever. Am I wrong/please teach me?
I can see why GI gets a bad rap regarding being scope-focused but I assume there is freedom to shape your own practice. During med school, I rotated onto clinics with a GI boss who mainly saw IBD patients. There is a LOT of cognitive work required to assess and manage these patients. He also had an esophageal disorder clinic (which was also intellectually stimulating) and he performed some pretty neat interventions (ERCP with biliary stenting, EUS-guided interventions, endoscopic treatment of Barret's ablation). Overall, it was a nice varied work life. Of course, he might not make anywhere near as much as the guy who scopes all day but he seemed pretty fulfilled.

The only thing I couldn't stand were the functional bowel presentations. Now those were tough!
Endoscopy is one of those things thats a lot more fun to do than to watch. Any procedural specialty gets repetitive. I personally find it much more satisfying to see what Im doing/where Im going and taking out polyps, etc, than for example heart caths and watching a wire on fluoro.

Yes IBS patients can be challenging. Nearly every speciality has their version of IBS though. You just need to set realistic expectations, and given the high placebo response, you can often make people feel a little better through diet/medication/lifestyle changes. Unless they are full blown crazy, you can often improve peoples quality of life, which can be satisfying.

As to the poop question, good/decent preps are usually odor free, and I can clean up what I need to with water and suction. Its the poor tone guys with bad preps that start leaking out stool that get annoying and smell/messy. I'll take poop over pulmonary secretions any day of the week.

Nothing quite smells like a necrosectomy though. Liquid death.
 
  • Like
Reactions: ShiShiMD and Merely