Question: My GI doctor keeps telling me that my abdominal pain is IBS, but the pain wakes me up at night and is worse after certain foods. Every time I bring this up he says something like, ‘that’s classic IBS.’ What can I do to push for more testing without sounding like I don’t trust him? I’m a 38 year old woman.

It’s incredibly frustrating when you’re experiencing pain that disrupts your sleep and affects your daily life, yet your concerns are repeatedly dismissed with the same diagnosis. Your instinct to seek more thorough evaluation shows strong self-advocacy, and there are communication strategies that can help you have more productive conversations with your provider.

Why This Communication Pattern Happens

The “that’s classic IBS” response you’re hearing reflects a common communication challenge in healthcare. Sometimes providers use familiar diagnostic labels as a way to quickly categorize symptoms, which can leave patients feeling unheard or like their concerns aren’t being fully explored.

The pattern you’re seeing, where symptoms get explained away with the same response, happens frequently. This is an especially common experience for women seeking care for abdominal complaints. When providers seem to have already made up their minds, it can feel impossible to get them to consider other possibilities or pursue additional investigation.

Strategies to Advocate for Thorough Evaluation

Document your symptoms strategically. Before your next appointment, create a detailed symptom diary for 2-3 weeks. Note specifically:

• How often you wake up at night due to pain (dates and times)
• Pain severity on a 1-10 scale when it wakes you
• Which foods trigger symptoms and how quickly
• Any other symptoms (changes in bowel habits, weight loss, fever, etc.)

When you present this documentation, you can say: “I’ve been tracking my symptoms carefully, and I’m consistently waking up 3-4 times per week due to abdominal pain. I’m concerned about the nighttime episodes and would like to discuss what additional evaluation might be appropriate.”

Ask direct questions about the diagnostic process. Instead of challenging the IBS diagnosis head-on, focus on understanding what’s been ruled out. Try phrases like:

• “What testing have we done to rule out other conditions that can cause similar symptoms?”
• “I’d like to understand what additional symptoms would prompt you to order more testing, because these nighttime episodes feel significant to me.”
• “Can we discuss what a complete workup typically includes for symptoms like mine?”

Request specific documentation in your chart. This is crucial for your ongoing care. Say something like: “I want to make sure my nighttime pain episodes are clearly documented in my chart, along with the food triggers I’ve identified. Can you note that I’m experiencing abdominal pain that wakes me from sleep?”

Getting this documented serves two purposes: it creates an official record of your symptoms, and it often prompts providers to think more carefully about next steps.

Advocate for additional evaluation. If you feel like not enough testing has been done, you can request it specifically: “I’d feel more confident about this diagnosis if we could do some additional testing to rule out other possibilities. What would that typically include for someone with my symptoms?”

Reframing for Collaboration

You can maintain a collaborative tone while still advocating firmly by positioning yourself as a partner in your care rather than a challenger of their expertise. Frame your requests around wanting to work together toward the right answers:

“I really want to get to the bottom of this so we can find the right treatment approach. I’m experiencing significant quality of life impact from these symptoms, especially the nighttime episodes, and I’d feel more confident moving forward if we could explore this more thoroughly.”

If your doctor seems resistant to additional evaluation, you can ask: “What would need to change about my symptoms for you to consider further investigation?” This puts the focus on their clinical reasoning and decision-making process.

Consider requesting a second opinion if resistance continues. You can frame this diplomatically: “I’d value getting another perspective on my symptoms before we finalize the treatment plan. Could you refer me to another GI specialist for a second opinion?”

Moving Forward

Keep in mind that the point of advocating for thorough medical care is to ensuring that you receive comprehensive evaluation. A good physician should welcome your detailed documentation and thoughtful questions about next steps.

If your current provider continues to dismiss your concerns without addressing the symptoms that worry you most, that’s valuable information about whether this is the right healthcare partnership for you. You deserve a provider who takes your symptoms seriously and is willing to explore your concerns thoroughly.

Your instinct to question a quick dismissal of concerning symptoms shows good self-advocacy. Trust that instinct, document everything carefully, and don’t stop advocating until you feel your concerns have been properly addressed. Getting answers that account for all of your symptoms is crucial for your peace of mind and your ongoing care.

This response provides guidance on patient advocacy and communication strategies. It is not intended as medical or legal advice. Always consult with qualified healthcare professionals about your specific medical concerns and treatment options.

Reader-submitted questions may be lightly edited for brevity and clarity, while preserving the original intent.