Unknown Illness for Tama (slightly gross)

[Tama]

I figured since someone else was getting some good, sound, advice about their unknown condition that I would see if anyone had any advice for me.

So here's what I got:

1. Constipation -- can range from 2 - 8 days of nothing, then, all at once and always with extreme pain. Like, doubling over while sitting, can't move or breathe type of pain. Lately, as in the last two months, I have this and the opposite problem minorly for a day or two following an incident.

2. The pain is located in my lower left and starts out sometimes just pain and sometimes like someone is squeezing my stomach like a balloon and I get nauseated. Once my body decides it has done enough of an exodus the pain goes away. Sometimes the pain moves...like, it feels like the pain's connected to a little ball that moves downward along with...well you know.

3. Had colonoscopy in November, was told they did not find anything. A CT in October was oddly done--at first I was told they found nothing, but the appointment I got to arrange the colonoscopy told me there was a lesion on my liver.

4. Periods have continued to happen earlier and earlier (5-7 days), and have gotten lighter and lighter. Usually the heavy main event took 3 days, now it's more like a day and a half with almost no flow after that time.

5. Lost weight. I was 160 about February of last year and within a couple months was down to 120, and now I'm 100. I can't hold weight to save my life.

6. The incident 1 month ago where I fainted at work. It was hot, I don't drink much water. My b/p was something like 93/60. Probably doesn't have much to do with my overall problem, but....

I'm working on getting a new job, with insurance, but since my agency won't let me back without a doctor's note saying I am okay to work, I can't...really, well...get to a doctor at present. I do want to try and figure out what's going on though.

Thanks for reading.

[Seshat]

Constipation can be caused by a few things.

* slow 'motility' in the bowel (ie, the food goes through the bowel slowly, and thus tends to dehydrate too much and get all compacted). This is usually either upper bowel or lower bowel, though my friend has both.
Motility issues can often be helped with more water in the diet, more fibre in the diet, or both. Maybe Panacea or one of our other nurses can clarify this for you - or talk to a pharmacist, they should be able to advise you on this too.

* Insufficient fluids in general. At the end of the digestive process, the colon and rectum reclaim the fluids the body has invested in the food. (Basically, the body shoves fluids in at the upper bowel, so that the food can move freely through the bowels.)
However, if you don't have enough fluid in your body in general, and don't have enough fluid intake, you can end up with not enough left in the former-food-now-stool for it to exit the body easily.

* There is a condition called paradoxical diahrrea (sp?) where you have a blockage of hardened stool, but some still-fluid material manages to slide around it.

* Probably there are other causes of constipation, one of our medicos can probably fill in for me.


NOW:

I'm going to once again refer someone to irritable bowel syndrome. That can cause both constipation and diahrrea. Yeah, weird, right?
You also might have food intolerances - basically, foodstuffs your particular bowel cannot digest. With my friend, it's most sugars. Including fructose, and the sugars in wheat (she goes for gluten-free foods to avoid those).
Studying irritable bowel syndrome sources should also refer you to food intolerance websites - the two are often connected.

Hopefully your problem is simply a motility one, and a simple-to-correct motility issue. The sort where you just add more fibre to your diet, or more fluids to your diet, depending on which is your issue.

The pain, btw, is caused by an over-hard amount of stool in your rectum, and by trying to essentially push out a baseball through your butt. Softer stool will reduce or remove the pain.

Edit to add: check out any anatomy page to understand why it's lower-left. Your descending colon is there, and that's where your stool is stored. Bowel anatomy

Edit again: while I don't recommend Wikipedia as an absolute-correct-gospel source of information for anything, it's often worthwhile using as an overview source. Read the 'pathologies of the colon' links at the end of the page I linked to above.
(DON'T freak out if you read something like the worst possible variation of Chron's disease or colon cancer or something and think it matches your symptoms! The most likely issue here is simple motility problems solveable with dietary changes. I'm just saying to read this so you can see what the possibilities are, and how to make lifestyle changes to hopefully help. Until you can see a doctor, you're going to have to try lifestyle changes. The good part is that for most bowel conditions, lifestyle changes WORK!)

Also, in one of the other threads about unknown-illness here (I think Kisa's), I recommended strengthening the pelvic floor muscles and the corset muscles. I recommend this to you, as well. It won't help directly, but it will help keep all the internal anatomy in its proper places.

[Sapphire Silk]

Seshat once again has summed up the basics fairly nicely.

I usually refer to the paradoxical diarrhea as "breakthrough diarrhea." Essentially, liquid stool backs up behind the blockage and eventually leaks around it and is expelled, sometimes violently.

I have Irritable Bowel Syndrome, the constipation variety. Basically, when stool enters my descending colon, it begins to spasm, causing it to not move forward. However, the colon continues to do its job of removing water, so I end up with constipation that is later followed by diarrhea. Once I finally move the stool, the liquid stool behind it is quickly and forcibly moved through my system.

If it sounds painful, it is.

Diet plays a big role in this. Usually I have a flare when I've been eating too much fat.

Tama, I doubt you have Chrohn's Disease. That involves inflammation that usually starts near the celiac end of the large intestine. It involves ulcerations of the bowel; that would have been spotted in a colonoscopy. Ditto for ulcerative colitis, which also involves bloody diarrhea. Ditto again for a diverticulum.

You could be dealing with celiac disease. That would explain the bowel issues as well as the weight loss as you are not absorbing nutrition as you should. The weight loss is very significant and you should follow up on this as best you can. Normally that kind of weight loss is a red flag for cancer.

The changes in your periods may be a reflection of malnutrition. Your body doesn't have the resources to produce a normal cycle so it doesn't. Once your weight gets back to normal, your periods should return to normal too (assuming I'm right).

The pain you describe with the constipation is fairly typical for constipation regardless of the cause. I think the constipation is a symptom, not the disease. In fact, I'm not convinced you are constipated at all since what you really seem to be reporting is diarrhea. What color is it? Is there a foul odor to it?

Failure to drink enough fluids can contribute to significant constipation, but does not explain the massive weight loss. It does explain the hypotension . . . or may not.

How do you feel otherwise? How's your sleep? How do you get through your day? How's your energy? Have you noticed any changes in your hair, nails or skin?

Celiac disease is a small intestine problem, so a colonoscopy would not spot it. Basically, the small bowel is unable to digest certain grains, specifically wheat family grains and their corresponding proteins (gliadin). An irritation to the bowel is produced and results in large volumes of foul smelling diarrhea (steotorrhea), weight loss, and malnutrition.

Here's a cheap test to see if I'm right. Eliminate all wheat, barley, and rye from your diet. Switch to eating only Gluten free foods for awhile and see if your symptoms go away and you start gaining weight. If you do, then it's a safe bet that's the problem. A gluten free diet may be challenging for awhile though, until you get used to it. It mainly affects breads, grain products and processed foods.

[Tama]

**Warning, Gross**







Energy is dismal unless I get caffeine, which I am loathe to give up. Because if I go without it too long I get colossally BAD headaches and even less energy than usual. Dry skin seems to be a problem. Sleep? I usually wake up several times before finally getting up for the day. Bit of a night-owl.

Also, I seem to be having minor chest pains lately. The pain occurs as my heart beats, but then I won't have a pain again for a long while. I also have frequent palpitations.

Diarrhea? Foul. Kind of an eggy/veggie smell, and burns like hell. And itself, is a kind of sun-yellow. I've also noticed floaters during the 1% of the non-painful BMs, which I'm told is because I'm not digesting fat properly.

Celiac, I have heard about quite often. And I've noticed that if I eat anything particularly fatty+processed, like takeout pizza or McDonalds, my stomach goes, "ME NO LIKEY!" = mass exodus.

I'll try that gluten-free thing first. Is there anything else besides wheat, barley, and rye to avoid?

[AnaKhouri]

I have heard (and I am not a doctor!) that thyroid issues can affect your bowels, your period, and your skin and hair (the dry skin thing made me remember this). It can also affect your weight and your energy levels.

Something worth thinking about. I think a simple blood test can diagnose it?

[Seshat]

Seshat once again has summed up the basics fairly nicely.

<takes a bow>

[Geek King]

Energy is dismal unless I get caffeine, which I am loathe to give up. Because if I go without it too long I get colossally BAD headaches and even less energy than usual.

This is likely classic caffine withdrawl. The headaches will go away over time if you stay away from the caffine. Alternately, you can slowly back down by alternating caffinated drinks with non-caffinated drinks for a few days, then backing it down further. I had to go cold-turkey off caffine for a test, and I was miserable for days, but it did get better. The doc said suddenly quitting caffine can cause the blood vessels to constrict in the brain, which registers as a severe headache. It didn't really help to know why I was miserable.

The good news is that after you've been off the caffine for awhile, it will take less to keep you awake until you're body builds up tolerances again.

[jedimaster91]

I have heard (and I am not a doctor!) that thyroid issues can affect your bowels, your period, and your skin and hair (the dry skin thing made me remember this). It can also affect your weight and your energy levels.

Something worth thinking about. I think a simple blood test can diagnose it?

This is what I was thinking. Significant, unexplained weight loss, heart palpitations, and restlessness are all classic hyperthyroid symptoms. The blood test is a good place to start, but if that comes back inconclusive the next step is usually a thyroid uptake/scan. PM me if you want more info about the scan since I do them.

I'd also see about getting your gallbladder checked. Normally gallbladder-related pains are on the right side instead of the left, however constipation and nausea are also symptoms of a bad gallbladder.

[Hermione]

I have to agree with a lot of the other posters.

The thyroid has a LOT more to do w/ digestion than a lot of people realize, so definitely get that checked. Easy peasy blood test.

If your stool has a lot of yellow color to it, that's bile. Be sure you get an abdominal ultrasound and gallbladder function test if needed.

I'd have a doc run a full liver function panel on your blood too if you havent already.

[Tama]

I had a thyroid blood test while I was in the ER, and they said nothing was wrong. When I can get insurance/medicaid/whatever, I'll see what I can do as far as more tests.

Sometimes I feel like I'm on an episode of House or something...

[Sapphire Silk]

Energy is dismal unless I get caffeine, which I am loathe to give up. Because if I go without it too long I get colossally BAD headaches and even less energy than usual. Dry skin seems to be a problem. Sleep? I usually wake up several times before finally getting up for the day. Bit of a night-owl.

Caffeine is addictive. The symptoms are probably withdrawal. It is also a stimulant, so that explains the fatigue getting worse when you don't take it.

Dry skin may or may not be related to your symptoms, but malnutrition can lead to it.

Also, I seem to be having minor chest pains lately. The pain occurs as my heart beats, but then I won't have a pain again for a long while. I also have frequent palpitations.

Now this is very concerning. You may have a potassium or other electrolyte deficiency that is causing the palpitations. Next time you get chest pain or palpitations, go to the ER, do not pass go, do not collect $200. You can work out a payment plan later. You could go into cardiac arrest if you don't.

Diarrhea? Foul. Kind of an eggy/veggie smell, and burns like hell. And itself, is a kind of sun-yellow. I've also noticed floaters during the 1% of the non-painful BMs, which I'm told is because I'm not digesting fat properly.

Celiac, I have heard about quite often. And I've noticed that if I eat anything particularly fatty+processed, like takeout pizza or McDonalds, my stomach goes, "ME NO LIKEY!" = mass exodus.

I'll try that gluten-free thing first. Is there anything else besides wheat, barley, and rye to avoid?

Here's some web sites you can check. http://www.celiac.com/, http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/, http://www.celiacdiseasediet.org/

Oatmeal is controversial. Some say it is OK, some not. Corn is OK.

Just bear in mind it is not just wheat but anything made from wheat starch, which is a lot of things, like candy, potato chips, rice mixes, sauces, and all sorts of things. So you'll need to read labels on EVERYTHING.

Some others here suggested a gallbladder problem. I think it unlikely because your symptoms don't include upper right quadrant pain, nor have you complained of right flank pain. But it IS a possibility and an evaluation should include the gallbladder.

You also mentioned a lesion on the liver. I overlooked this in my original post. Cancer could be a possibility and you should follow up on that lesion. It could explain the massive weight loss (though it does not explain the diarrhea).

If you have more chest pains or palpitations GO TO THE ER!. Tell the doc the whole story you told here, so they give you a complete workup and don't stick to the typical EKG-cardiac enzymes rule out MI workup.

Keep us posted!

[Tama]

If I went to the ER every time I had palpitations I would be in there long-term. I have them every day. But I see what you mean by that...I had a Holter monitor for a few days, but as they send the data to the ER doc, and I haven't heard back. I was told if there was a major, OMG emergency they'd call, and they haven't.

I'm going to try to get on Medicaid, or something. Cancer? I sure hope not...frankly, it would be the icing atop the cake of a *lovely* year.

Frankly, I'm wondering if I might have some sort of infection relating to my teeth which are not in the best condition...

Could it have been the weight loss that caused the lesion? That's what I was hoping, because I was told that too much weight loss can damage the liver.

I know I'm probably wrong, but I was curious.


And I do have occasional right-side pain, in the middle. It just doesn't happen often enough for me to have any serious complaints about it.

[Sapphire Silk]

Well, at least you've had it evaluated.

Yes, the lesion could be damage from the weight loss, if the weight loss is caused by something else (I'm still leaning towards a GI problem like celiac disease based on your symptoms). The weight loss is also likely responsible for the dental problems: in malnutrition, decalcification of bone (including teeth) can occur, and you can also have other dental problems with the gums and so forth. Reversing malnutrition can reverse some of the dental problems.

The pain you describe could be the gall bladder, but more likely the pancreas. Pancreatitis can be caused by alcohol, a gall stone, cancer, an infection, and some other issues. It is excruciatingly painful, and usually accompanied by nausea and vomiting.

That's the problem with GI: there are so many organs and systems it can take a lot of workup to figure out.

Do try and get Medicaid. At least then you'd have something.