Preparing for Consultation with a Gastroenterologist

Consultation with a Gastroenterologist

If you have an enteropathy, it’s likely your healthcare professional will refer you to a gastroenterologist. As a gastroenterologist with special expertise in IBS (irritable bowel syndrome) and enteropathy, I’ll be your guide in this article, so you’ll be prepared for your consultation.

Introduction to IBS and Enteropathy

If you haven’t already done so, begin by reviewing our two introductory articles:

Your Enteropathy Triad

You now know that enteropathy refers to a triad of the most common gastrointestinal or “gut” symptoms:

  • Abdominal pain and/or discomfort
  • Gas (abdominal bloating, distention, flatulence, and/or gurgling — rumbling)
  • Bowel dysfunction (diarrhea, constipation, or both)

About two of three people with enteropathy report that eating triggers their symptoms. For more details on the relationship of food with enteropathies, you can review Article 5.

IBS Is likely to Be Your Initial Diagnosis

Article 3 discusses IBS. If you have these enteropathy symptoms and don’t have any “red flag” concerning features listed in Article 3, such as blood in the stool and unexplained weight loss, you’re probably going to be diagnosed with IBS. In my opinion, accepting an initial diagnosis of IBS is not OK until you are:

Educated + Enlightened = Empowered

That’s what our enteropathy series here is all about.


Take these steps so you can collaborate effectively with your healthcare professionals, including gastroenterologists.


Don’t accept an initial diagnosis of IBS!

Most doctors may not be familiar with the ICD-10 Diagnosis Code K63.9: Disease of Intestine, unspecified. In most cases, it’s in your best interest to be diagnosed with an enteropathy rather than IBS. Alternatively, diagnostic coding for symptoms can be given, such as:

  • Abdominal pain
  • Abdominal bloating and distention
  • Constipation
  • Diarrhea

Here’s why.

Figure 8.1 is a graphic depiction of your “differential diagnosis.”

differential diagnosis
Figure 8.1


What else could this be?

Differential diagnosis is the process of considering ALL possibilities that are either causing or contributing to the enteropathy triad of symptoms.

In Article 3, I explained that IBS is the most common initial diagnosis made. This diagnosis usually blocks and blinds both the patient and doctor from considering other differential diagnoses and their interrelationships shown in Figure 8.1.

Once an “initial diagnosis” of IBS is made — even though “red flag” concerning features aren’t present — It’s likely that a colonoscopy will be scheduled.


In Figure 4.1 and the discussion in Article 4, I discussed your map of differential diagnosis, reaching the following conclusion: Most of the time, a noninvasive diagnostic approach can be taken, including blood, stool, and breath tests. Colonoscopy and imaging with scans may well not be necessary. Remember, sometimes more than one diagnosis to be present, such as IBS (Article 3) and Sucrose Intolerance (Article 6).

The views, opinions, and positions expressed by the authors and those providing comments on these blogs are theirs alone and do not necessarily reflect the views, opinions, or positions of

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