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Family Medicine (Expert Forum)
Episodic Symptoms
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Episodic Symptoms
by ishamel, Jul 14, 2003 12:00AM
I am a 37-year old male suffering from episodes of symptoms that doctors have been unable to successfully diagnose. It begins with intense pain in the hand/wrist and/or knee/feet. Then I get light headed and kind of cloudy in the head. I then have to go to the bathroom but very little comes out; it is a small, narrow, fully formed stool. I have the feeling that my bowel has not completely emptied. The lightheaded/cloudy continues; the pain persists; and I keep having to go to the bathroom. Each time only a little comes out. Feelings of anxiety begin to appear then. This episode can continue for a few hours. It has, as one might expect, become a quality of life issue.
Any ideas?
Any ideas?
Doctor's Answer
by Kevin Pho, MD, Jul 14, 2003 12:00AM
, Jul 14, 2003 12:00AM
Hello - thanks for asking your question.
I cannot think of a diagnosis that ties all of your symptoms together. Without examining you it would be difficult to come up with something that your doctors haven't.
Regarding the narrow stools - any change in stool caliber would be a reason to perform an endoscopy. Any type of polyp or mass can result in that symptom and should be evaluated. In combination with tenesmus (i.e. your bowel not feeling completely empty) amplifies the reason why an endoscopy should be performed.
Regarding the joint pain and dizziness, I would obtain a basic metabolic panel, complete blood count, ANA level and ESR to make sure that there are no overt diseases causing your discomfort. A referral to a rheumatologist can be considered for further evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
I cannot think of a diagnosis that ties all of your symptoms together. Without examining you it would be difficult to come up with something that your doctors haven't.
Regarding the narrow stools - any change in stool caliber would be a reason to perform an endoscopy. Any type of polyp or mass can result in that symptom and should be evaluated. In combination with tenesmus (i.e. your bowel not feeling completely empty) amplifies the reason why an endoscopy should be performed.
Regarding the joint pain and dizziness, I would obtain a basic metabolic panel, complete blood count, ANA level and ESR to make sure that there are no overt diseases causing your discomfort. A referral to a rheumatologist can be considered for further evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments
by nmc, Jul 23, 2003 12:00AM
To: Ishamel
Just a thought - do a search for Fabry's disease and check your symptoms (especially the limb/joint pain & mind fog) against those listed.
