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Gastroenterology (Expert Forum)
What could this be
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.
What could this be
by Gerardina, Dec 28, 2003 12:00AM
Ten years ago I got a gastrointestinal infection , food related. I was examined on salmonella but that was negative. My livervalues were up and I was told that they should be looked at when I got back from my holiday .By that time they were nearly back to normal and it was left at that.I forgot about the infection. However from that time on I was feeling tired having flue like symptoms all the time and a lot of sinusitus problems continually. My stools smelled awfull ( sour smelling) and are loose all the time.Because at that time I had a lot of stress in my life I thought this had all to do with the stress. Five years later I discovered by accident that my reactions were partly as a result of intake of lactose.The reaction to lactose starts twelve to eighteen hours later; I get terrible migraines lasting three or four days, strong influenza symptoms, I get mucusreactions in my whole body: I am not able to breathe easily ( the mucus is very though and brown, yellowish of color), a lot of dhiarea smelling very sour and a kind of shiny, a vaginal discharge which is often yellowish brown and stringy.The reaction takes six weeks before I am back to normal. Bit by bit I discovered that I seems that am not able to eat carbohydrates.
I have had a lactose intolerance test;that turned out negative
I am pretty desperate : eating is not a pleasurable event. Most of the time I am tired often very shaky after I had some sugar ingested. At this moment my diet exists mostly of rice and chicken and very little other things for the last four years.
I have a few questions: has anybody ever heard of this; is it normal for a reaction to occur so late and last so long , to whom can I go to figure out what I am up at
I have had a lactose intolerance test;that turned out negative
I am pretty desperate : eating is not a pleasurable event. Most of the time I am tired often very shaky after I had some sugar ingested. At this moment my diet exists mostly of rice and chicken and very little other things for the last four years.
I have a few questions: has anybody ever heard of this; is it normal for a reaction to occur so late and last so long , to whom can I go to figure out what I am up at
Doctor's Answer
by Kevin Pho, MD, Jan 04, 2004 12:00AM
, Jan 04, 2004 12:00AM
The classic manifestations of malabsorption are diarrhea with pale, greasy, voluminous, foul-smelling stools and weight loss despite adequate food intake.
Carbohydrate malabsorption may be a possibility, given the fact that you are sensitive to carbohydrates. In addition to the lactose intolerance test, there are other tests to consider.
This would include the D-xylose test which measures the absorptive capacity of the proximal small intestine. Breath tests using H2, 14CO2, or 13CO2 can be used to diagnose specific forms of carbohydrate malabsorption (eg, lactose, fructose, sucrose isomaltase and others). Combined with serial determinations of D-xylose absorption, these tests can also monitor patients during treatment.
I would discuss these further tests with your personal physician. A gastroenterology referral would also be advised. If these malabsorption tests are negative, I would suggest discussing a colonoscopy.
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.
Carbohydrate malabsorption may be a possibility, given the fact that you are sensitive to carbohydrates. In addition to the lactose intolerance test, there are other tests to consider.
This would include the D-xylose test which measures the absorptive capacity of the proximal small intestine. Breath tests using H2, 14CO2, or 13CO2 can be used to diagnose specific forms of carbohydrate malabsorption (eg, lactose, fructose, sucrose isomaltase and others). Combined with serial determinations of D-xylose absorption, these tests can also monitor patients during treatment.
I would discuss these further tests with your personal physician. A gastroenterology referral would also be advised. If these malabsorption tests are negative, I would suggest discussing a colonoscopy.
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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Happy holidays,
Kevin, M.D.
If it is a carbohydratemalabsorption what kind of treatment can I expect?