My skin was highly inflamed for a really long time (years). I saw several doctors about it (GI, GYN, and internist). They tried various medications but none really helped. Finally, one of them referred me to a dermatologist who had a specialty in the vulva area. I saw her for almost a year with some progress. She eventually referred me to another dermatologist who did patch testing for skin allergies. The results were enlightening, to say the least. I found out that I am allergic to a lot of stuff ... things that are contained in almost everything on the market, including some of the topical medication that I've used and nearly every other product I used (i.e., soap, detergents, makeup, etc). I now have a "safe" list of products to choose from.
I'm seeing the vulva dermatologist again and we are still trying to find the right balance of topical drugs; things have improved tremendously though since I began using products from the "safe" list.
My gastroenterologist was the one who referred me to the physical therapist who specializes in the pelvic floor. I was so constricted, none of the dilators would have worked a few months ago. Things are much better now. I haven't seen the GI since she referred me to the physical therapist but I know the physical therapist sends her regular updates on my progress so I assume the GI is aware of the dilator use through those reports.