From the Guidelines
If your healthcare providers are not performing physical exams, alternative monitoring strategies such as self-monitoring, digital health tools, telemedicine appointments, laboratory testing, and imaging studies can help track your health. These strategies can provide essential information for managing your condition and detecting any changes or abnormalities early on. Some key alternatives include:
- Self-monitoring through regular self-examinations and keeping a detailed symptom journal to note changes in bowel habits, urinary patterns, pain, or other symptoms 1
- Using digital health tools like blood pressure monitors, glucose meters, and symptom tracking apps to provide objective data 1
- Telemedicine appointments for visual assessments and symptom discussions, which can be particularly useful when in-person exams are not possible 1
- Laboratory testing, including blood work, urinalysis, and stool tests, to detect abnormalities without the need for a physical examination 1
- Imaging studies such as ultrasounds, CT scans, or MRIs, which offer detailed internal views and can be used to monitor conditions when physical exams are not feasible 1 It's also important to consider seeking second opinions from other specialists who may perform physical exams, as these remain a crucial part of standard care for many conditions. Patient advocacy is key - clearly communicate your concerns about the lack of physical examination and request appropriate alternative monitoring methods based on your specific health conditions. Regular monitoring helps detect changes early, allowing for timely intervention before conditions worsen. In the context of inflammatory bowel disease (IBD), for example, non-invasive tests such as stool and blood exams, cross-sectional imaging like bowel ultrasonography or magnetic resonance enterography (MRE), and patient-reported outcomes (PROs) can play a significant role in monitoring disease activity and adjusting treatment plans accordingly 1.
From the Research
Alternative Monitoring Strategies
If the gastroenterologist, urologist, or Primary Care Physician (PCP) are not performing physical exams, several alternative monitoring strategies can be employed:
- Intestinal ultrasound: This non-invasive, real-time imaging tool can be used to monitor inflammation in patients with inflammatory bowel disease (IBD) 2.
- Patient-reported outcomes: Tools such as the Bristol Stool Form Scale (BSFS) and visual analog scale (VAS) for abdominal pain can be used to monitor patients with Crohn's disease 3.
- Fecal calprotectin tests: Rapid fecal calprotectin tests can be used to detect mucosal inflammation in ulcerative colitis and Crohn's disease 4.
- Biomarkers: C-reactive protein (CRP), fecal calprotectin (FC), and stool lactoferrin (SL) can be used to assess endoscopically defined disease activity in IBD 5.
- Non-invasive monitoring tools: Venipuncture, ultrasonography, and wireless capsule endoscopy are more acceptable to patients than invasive procedures like colonoscopy and rectosigmoidoscopy 6.
Benefits of Alternative Monitoring Strategies
These alternative monitoring strategies offer several benefits, including:
- Reduced need for invasive procedures
- Increased patient acceptability and adherence to monitoring
- Faster diagnosis and treatment
- Reduced costs associated with endoscopic procedures
- Improved patient outcomes through earlier detection and treatment of disease activity 2, 3, 4, 5, 6.
Considerations for Implementation
When implementing these alternative monitoring strategies, considerations should be given to: