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Preparing for your appointment

By Mayo Clinic staff

Symptoms of Crohn's disease may first prompt a visit to your family doctor or general practitioner. However, you may then be referred to a doctor who specializes in treating digestive disorders (gastroenterologist).

Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, as well as any vitamins or supplements, that you're taking.
  • Ask a family member or friend to come with you to your appointment, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your visit. List your questions from most important to least important in case time runs out. For Crohn's disease, some basic questions to ask your doctor include:

  • What's causing these symptoms?
  • Are there other possible causes for my symptoms?
  • What kinds of tests do I need? Do these tests require any special preparation?
  • Is this condition temporary or long lasting?
  • What treatments are available, and which do you recommend?
  • Are there any medications that I should avoid?
  • What types of side effects can I expect from treatment?
  • Are there any alternatives to the primary approach that you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Do I need to follow any dietary restrictions?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?
  • Is there a risk to me or my child if I become pregnant?
  • Is there a risk of complications to my partner's pregnancy if I have Crohn's disease and father a child?
  • What is the risk to my child of developing Crohn's disease if I have it?
  • What are the best sources of information to learn about Crohn's disease?
  • Are there support groups for people with Crohn's and their families?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or intermittent?
  • How severe are your symptoms?
  • Do your symptoms affect your ability to work or do other activities?
  • Does anything seem to improve your symptoms?
  • Is there anything that you've noticed that makes your symptoms worse?
  • Do you smoke?
  • Do you take nonsteroidal anti-inflammatory medications (ibuprofen, naproxen, diclofenac, others)?
Tests and diagnosis Complications
References
  1. Crohn's disease: Clinical features. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Saunders Elsevier; Philadelphia, Pa.: 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/810.html?tocnode=51643270&fromURL=810.html#4-u1.0-B1-4160-0245-6..50113-X--cesec14_5163. Accessed June 21, 2009.
  2. Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/. Accessed June 21, 2009.
  3. Crohn's disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec02/ch018/ch018b.html. Accessed June 17, 2009.
  4. Peppercorn MA. Clinical manifestations, diagnosis and natural history of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
  5. Living with Crohn's disease. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/crohns2005.pdf. Accessed June 17, 2009.
  6. Werman HA, et al. Ileitis, colitis, and diverticulitis. In: Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, N.Y.: McGraw Hill; 2004. http://www.accessmedicine.com/content.aspx?aID=592744. Accessed June 21, 2009.
  7. Learning about Crohn's disease. National Human Genome Research Institute. http://www.genome.gov/pfv.cfm?pageID=25521854. Accessed June 17, 2009.
  8. Inflammatory bowel disease. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/144932667-4/854785995/1621/261.html#4-u1.0-B978-1-4160-4435-2..50133-3--cesec17_2085. Accessed June 21, 2009.
  9. Accutane (prescribing information). Nutley, N.J.: Roche. 2008. http://www.rocheusa.com/products/accutane/pi.pdf. Accessed June 23, 2009.
  10. Draganov PV. Colorectal cancer surveillance in inflammatory bowel disease: The search continues. World Journal of Gastroenterology. 2009;15:61.
  11. Ingle SB, et al. The natural history of perianal Crohn's disease. Digestive and Liver Disease. 2007; 39:963.
  12. Piton G, et al. Big risk, small risk: Small bowel cancer in Crohn's disease. Inflammatory Bowel Diseases. In press. Accessed June 23, 2009.
  13. Crohn's disease: Treatment. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/813.html?tocnode=51643292&fromURL=813.html#4-u1.0-B1-4160-0245-6..50113-X--cesec36_5185. Accessed June 21, 2009.
  14. Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
  15. FDA approves new treatment for Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
  16. FDA approves Cimzia to treat Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
  17. FDA approves Tysabri to treat moderate-to-severe Crohn's disease: Drug currently approved for use in treating some forms of multiple sclerosis. Accessed June 23, 2004.
  18. Diet and nutrition. Crohn's and Colitis Foundation of America. http://www.ccfa.org/info/diet. Accessed June 23, 2009.
  19. Markowitz J, et al. Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2004;10:599.
  20. Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
  21. Korzenik JR. Investigational therapies in the medical management of Crohn's disease. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
  22. Picco MF (expert opinion). Mayo Clinic. Jacksonville, Fla. July 9, 2009.
  23. Follow-up to the June 4, 2008, early communication about the ongoing safety review of tumor necrosis factor (TNF) blockers (marketed as Remicade, Enbrel, Humira, Cimzia and Simponi). Food and Drug Administration. Accesed August 4, 2009.

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Aug. 8, 2009

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