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Gastroenterology (Expert Forum)
BOWEL PROBLEM - SEVERE FATIGUE
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
BOWEL PROBLEM - SEVERE FATIGUE
by meehan2003, Jun 18, 2003 12:00AM
Last week in April :
The day before slight discomfort pain began, was out in night club, drinking from cans (cider), one thing did notice was a funny smell from top of cans.
Woke up following day with slight discomfort in my lower left, I severely tired that day. Fatigue continued for three days, until awoke, with sudden feeling I was going to pass out, and very bad rigors (shaking).
The discomfort continued, I would have 2-3 days when I would feel 100% healthy, and then get severe fatigue, followed by episode of rigors for about 2-3 days.
The discomfort only turned to a pain after about week 6.
Also pain under rib cages, week 5-6 on….
This continued for about one week, and then consulted my doctor:
Week 2 :
Treated for Urinary Tract Infection, with SURPRAX.
(NEVER HAD UTI INFECTION)
Week 3:
Treated again for Urinary Tract Infection with ZINNAT.
Ultra sound for Kidney Stones
Week 4, 5, 6, 7:
First time admitted to Louth Hospital.
All Blood tests done, another ultra sound.
Same episodes continued, feeling o.k.for 2 -3 days, then feel terrible.
Was put on a general antibiotic.
Put camera down into my stomach.
Doctor Knox, put me on ZOTON.
• Second time admitted to Louth Hospital.
Only time I got diarrhea.
Passed blood.
Put camera up my back passage, found the
inflammation.
Was put on ASACOLON, AND ENEMA PREDFOAM
Third time admitted to Louth Hospital
Woke up feeling severely weak, went into
casualty, As soon as I was about to pass out, a
sudden rush of fluid in my bowel, within 30
minutes, felt allot better.
Discomfort moved to right side, also pains
under both rib cages.
Severe Fatigue, disoriented, restless, vivid dreams.
Feeling tired most days now.
*Started Steroids on Sunday 1st of June.
Week 7:
Wednesday 11th of June, discharged from hospital.
That evening, started getting severe fatigue again, eyes rolling in my head. (feeling when you get bad food poisoning)
Woke up at about 4am, again the SUDDEN rush of fluid in my bowel.
Got severe fatigue again, when started on ASACOLON on Thursday 12th June, Severe sore legs and knee joints. Stopped ASACOLON on Sunday 15th June. Felt allot better since.
Sunday 15th / Monday 16th June … Paper cut pains in bowel, more severe when walk about, Sore to touch.
Vivid dreams, fatigue, bloated feeling, pain now
Stools completely normal.
Appetite completely normal.
NEVER any cramps.
LOST over one stone in last seven weeks.
18th June -
Gettin waves of sweaty hands / dizzinesss, cutting pains in front and back
Present Treatment:
• 5 Steroid tablets in morning
• 1 Zoton (STOPPED TAKING)
• Buscopan (1 or 2 a day)
• Zydol for pain (STOPPED TAKING)
• ASACOLON (STOPPED TAKING)
The day before slight discomfort pain began, was out in night club, drinking from cans (cider), one thing did notice was a funny smell from top of cans.
Woke up following day with slight discomfort in my lower left, I severely tired that day. Fatigue continued for three days, until awoke, with sudden feeling I was going to pass out, and very bad rigors (shaking).
The discomfort continued, I would have 2-3 days when I would feel 100% healthy, and then get severe fatigue, followed by episode of rigors for about 2-3 days.
The discomfort only turned to a pain after about week 6.
Also pain under rib cages, week 5-6 on….
This continued for about one week, and then consulted my doctor:
Week 2 :
Treated for Urinary Tract Infection, with SURPRAX.
(NEVER HAD UTI INFECTION)
Week 3:
Treated again for Urinary Tract Infection with ZINNAT.
Ultra sound for Kidney Stones
Week 4, 5, 6, 7:
First time admitted to Louth Hospital.
All Blood tests done, another ultra sound.
Same episodes continued, feeling o.k.for 2 -3 days, then feel terrible.
Was put on a general antibiotic.
Put camera down into my stomach.
Doctor Knox, put me on ZOTON.
• Second time admitted to Louth Hospital.
Only time I got diarrhea.
Passed blood.
Put camera up my back passage, found the
inflammation.
Was put on ASACOLON, AND ENEMA PREDFOAM
Third time admitted to Louth Hospital
Woke up feeling severely weak, went into
casualty, As soon as I was about to pass out, a
sudden rush of fluid in my bowel, within 30
minutes, felt allot better.
Discomfort moved to right side, also pains
under both rib cages.
Severe Fatigue, disoriented, restless, vivid dreams.
Feeling tired most days now.
*Started Steroids on Sunday 1st of June.
Week 7:
Wednesday 11th of June, discharged from hospital.
That evening, started getting severe fatigue again, eyes rolling in my head. (feeling when you get bad food poisoning)
Woke up at about 4am, again the SUDDEN rush of fluid in my bowel.
Got severe fatigue again, when started on ASACOLON on Thursday 12th June, Severe sore legs and knee joints. Stopped ASACOLON on Sunday 15th June. Felt allot better since.
Sunday 15th / Monday 16th June … Paper cut pains in bowel, more severe when walk about, Sore to touch.
Vivid dreams, fatigue, bloated feeling, pain now
Stools completely normal.
Appetite completely normal.
NEVER any cramps.
LOST over one stone in last seven weeks.
18th June -
Gettin waves of sweaty hands / dizzinesss, cutting pains in front and back
Present Treatment:
• 5 Steroid tablets in morning
• 1 Zoton (STOPPED TAKING)
• Buscopan (1 or 2 a day)
• Zydol for pain (STOPPED TAKING)
• ASACOLON (STOPPED TAKING)
Doctor's Answer
by Kevin Pho, MD, Jun 19, 2003 12:00AM
, Jun 19, 2003 12:00AM
Hello - thanks for asking your question.
You are being treated for inflammatory bowel disease from your description.
To answer your questions:
1) Inflammatory bowel disease can certainly cause severe fatigue, depending on whether it is appropriately controlled or not. Electrolyte abnormalities, blood loss and infection are possible contributing factors. I would obtain an electrolyte panel and blood count for further evaluation. Another consideration would be medications. I would discuss all the medications you are taking with your personal physician to see whether they are contributing to your fatigue.
2) It is possible that an infection is present. However, you stated that stools were normal. If not already sent, I would test the stools for ova/parasites, culture, and giardia. If you continue to have loose stools, then a repeat endoscopy could be performed to definitively comment on whether there is an infection contributing to your symptoms.
3) As to the waves of fluid. One possibility may be ascities (i.e. free fluid within the abdominal cavity). An abdominal ultrasound should be considered to evaluate for this.
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.
You are being treated for inflammatory bowel disease from your description.
To answer your questions:
1) Inflammatory bowel disease can certainly cause severe fatigue, depending on whether it is appropriately controlled or not. Electrolyte abnormalities, blood loss and infection are possible contributing factors. I would obtain an electrolyte panel and blood count for further evaluation. Another consideration would be medications. I would discuss all the medications you are taking with your personal physician to see whether they are contributing to your fatigue.
2) It is possible that an infection is present. However, you stated that stools were normal. If not already sent, I would test the stools for ova/parasites, culture, and giardia. If you continue to have loose stools, then a repeat endoscopy could be performed to definitively comment on whether there is an infection contributing to your symptoms.
3) As to the waves of fluid. One possibility may be ascities (i.e. free fluid within the abdominal cavity). An abdominal ultrasound should be considered to evaluate for this.
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.
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The Biopsy report said there was only slight inflammation and cuts
Could it be an infection I have ?
What about the sudden rush of fluid feeling ?
Also my bloods/stools are completly normal