In gastrointestinal diseases, the true challenge for doctors lies in identifying the underlying causes.
“Physicians must grasp the big picture, understand the mechanisms, and comprehend the comprehensive interconnections of this system.”
The gastrointestinal and hepatic systems are intricately interconnected; even slight disturbances can lead to illness, which is reflected in the common saying, 'stress down to the stomach,' illustrating how various systems in the body are interrelated and can influence one another.
Today, we have the pleasure of speaking with Dr. Sureeporn Jangsirikul, a gastroenterologist and hepatologist at the Digestive Disease and Liver Center, MedPark Hospital. She will share her professional experiences and shed light on the fascinating perspectives and challenges of understanding diseases alongside patients.
Gastroenterologists are versatile
During her internal medicine residency, she crossed paths with many attractive subspecialties. However, not until her compulsory medical service stint did she have a chance to observe internal organs in the endoscopy room, sparking her interest.
“Being a general internist primarily involves using knowledge to communicate with patients. Upon discovering gastroenterology and hepatology, I realized that this specialty not only allows me to utilize my medical expertise but also enables me to perform hands-on procedures. I find this aspect particularly fascinating.”
Another reason she chose gastroenterology is the versatility of endoscopy. Aside from enabling visualization of the digestive tract, it also allows for interventions, treatment, tissue biopsy, and stopping bleeding, all within the same procedure. These align with her interests in both academic pursuits and hands-on practice. The array of procedures and techniques to master keeps the field engaging and prevents monotony.
The gastrointestinal system: Bigger and more intricate than she had envisaged
Upon embarking on a gastroenterology residency, the doctor discovered a level of complexity that surpassed initial expectations. The specialty encompasses hepatology, requiring liver function reviews, tissue biopsies, and X-ray interpretations. Additionally, gastroenterologists manage patients with irritable bowel syndrome (IBS), acid reflux, and bowel movement disorders and analyze gut bacteria.
“A distinguishing feature of the digestive system is its vast expanse because it comprises numerous specialized organs, including the esophagus, stomach, small intestine, large intestine, liver, and pancreas. When diseases or abnormalities arise, they may affect multiple organs and components within the system. Consequently, physicians must be able to view the system holistically and comprehend its underlying mechanisms and interconnectedness.”
In certain patients, one doctor visit cannot resolve their medical issues. Multiple consultations may be necessary to gradually identify the root cause of their symptoms, which is particularly true for conditions like IBS (Irritable Bowel Syndrome), where the underlying causes are often unclear and complex.
“I often find it necessary to engage in lengthy conversations with my patients, carefully gathering their medical history, because the root cause of their symptoms and the most effective treatment approach may not be immediately apparent. Often, we recommend certain medications as a trial, and while it may help some patients, others may not experience the desired relief. In such cases, I appreciate it when they return to me for further evaluation. Their feedback allows us to continue exploring potential causes and try alternative treatment options until we find the most suitable approach that leads to their improvement.”
“As a doctor, it is disheartening to witness patients who have sought help from various hospitals and undergone numerous tests and procedures, including endoscopies, yet remain without a diagnosis or effective treatment. Their suffering can last for years, causing immense distress. However, when a patient finally experiences improvement under my care, resulting from our combined efforts and their treatment adherence, it brings me a profound sense of pride and joy. These small victories, achieved through perseverance and collaboration, convey the deep fulfillment I derive from helping patients overcome their medical challenges.”
IBS: Even doctors are not sure about its causes
While Irritable Bowel Syndrome (IBS) is not inherently difficult to understand, the true challenge lies in effectively communicating the complexities of this condition to patients. IBS can arise from many disparate factors, necessitating a personalized approach to identifying the root cause in each individual, which often requires a significant investment of time and effort from healthcare providers.
“Patients often inquire about the underlying cause of their IBS, seeking a straightforward answer. However, the truth is that I, as a doctor, may not always have a definitive explanation. The origins of IBS could be a previous gastrointestinal infection or due to physical and emotional stress. The challenge lies in unmasking these underlying causes, as some patients may not consciously recognize the presence of stress in their lives. Without identifying the root cause, effective treatment becomes elusive.”
Does this mean IBS treatment could vary from person to person?
“Yes, indeed. The treatment approach for IBS varies depending on the individual circumstances. While some patients may benefit solely from medications that target the digestive system, others may require anxiety medications. However, not all patients are readily receptive to the idea of taking anxiety medication, primarily due to concerns about potential side effects. Consequently, I often have to devote a significant amount of time to engaging in open discussions with my patients, building rapport, and addressing their apprehensions before they fully embrace the treatment plan.”
Dr. Sureeporn wishes to assure IBS patients that while the condition is challenging to treat and can disrupt daily life, it is not life-threatening. She encourages patients to actively participate in their treatment by collaborating with her to determine the most effective approach. Additionally, patients should understand their symptoms and abnormalities to make appropriate medication adjustments under her guidance, such as adjusting dosage or switching medications in response to specific symptoms.
Can IBS recur?
“IBS can recur if the IBS-induced lifestyles or factors, such as stress or infection of the stomach or intestine persists. Therefore, if you experience any abnormal symptoms, it is advisable to consult a specialist.”
Unwinds Watching Documentaries After Work
Due to her hectic schedule, Dr. Sureeporn admits she lacks time for hobbies or other activities. However, she often finds relaxation by watching documentaries and semi-documentary programs on YouTube. These engaging shows broaden her horizons and introduce her to new and fascinating stories. Here are some of her favorite channels:
- Faroes / Farose Podcast
- The Common Thread
- Around the World by Karuna
“I find these channels appealing because they present information in an engaging and easy-to-understand manner. They break complex topics into enjoyable segments, sometimes incorporating entertainment while conveying valuable knowledge.”
In addition to her medical practice, Dr. Sureeporn harbors an interest in exploring investment opportunities. She also aspires to incorporate more regular exercise into her routine to achieve a healthier work-life balance. Currently, she focuses on striking a balance between her professional commitments and personal well-being.
Final words from our gastroenterologist
Before bidding farewell, Dr. Sureeporn offered valuable advice on recognizing signs and symptoms related to the digestive system and liver that we should not ignore.
She emphasized, “One often-neglected symptom is unexplained weight loss. Many people may dismiss it as inconsequential, attributing it to stress or reduced food intake. It behooves one to evaluate whether the weight loss is consistent with current lifestyle and habits because unexplained weight loss can be concerning and might signal the most dreaded scenario for both doctors and patients: cancer.”
Subtle shifts in our bodies, even without overt signs and symptoms of illness, warrant our attention. Unexplained weight loss, for instance, should not be dismissed as a mere innocuous happenstance. A thoughtful examination of current lifestyle and habits is crucial. Is this weight loss consistent with your usual routines and dietary choices? Unexplained weight loss can be an early sentinel, a silent indicator of a potentially more concerning underlying condition.
