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Gastroenterology (Expert Forum)
post ileostomy pruritus
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.
post ileostomy pruritus
by aljoby, Jan 27, 2006 12:00AM
I am a British physician. 10 years ago I had an ileostomy and internal for intractable ulcerative colitis. Shortly after discharge from hospital with an ileostomy bag I noticed severe itching all over my legs and then over my body. Nothing helped. When the ileostomy was connected to the pouch in hospital some 6 months later I developed an obstruction and for a week was on a drip. During this time the itching disapeared. My first food was a milky chocolate drink and immediately the itching re-commenced. I thought I was allergic to milk protein and stopped drinking milk. There was some improvement but from time to time the itching would flare up on my ankles and thighs. Recently I started itching on my face at night; then during the day and now over the whole of my body. The facial itching is very unpleasant with a pricking burning feeling resulting in insomnia. I have been on a strict dairy free diet, stopped all my drugs - including atorvastatin, been on an exclusion diet - to no avail. When I fast the itching stops; when I start eating again it returns. Recently I have had attacks of diarrhoea.
I am at a loss to account for it. Is it some sort of Vit B deficiency? I am normal weight for my height and otherwise in good health. Non smoker, very light drinker. On one occassion recently my bilirubin was 26 declining to 21.
Aljoby
I am at a loss to account for it. Is it some sort of Vit B deficiency? I am normal weight for my height and otherwise in good health. Non smoker, very light drinker. On one occassion recently my bilirubin was 26 declining to 21.
Aljoby
Doctor's Answer
by Kevin Pho, MD, Jan 28, 2006 12:00AM
, Jan 28, 2006 12:00AM
Difficult to say.
A referral to an allergist to determine any food allergies that may have developed in the interim.
I have also seen cases where patients were allergic to the ileostomy bag or tape itself - leading to the itching.
The elevated bilirubin level can be considered as well. Disease like PBC or PSC can lead to itching, and can be discussed with your gastroenterologist if this is suspected.
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.
Kevin, M.D.
kevinmd_b
A referral to an allergist to determine any food allergies that may have developed in the interim.
I have also seen cases where patients were allergic to the ileostomy bag or tape itself - leading to the itching.
The elevated bilirubin level can be considered as well. Disease like PBC or PSC can lead to itching, and can be discussed with your gastroenterologist if this is suspected.
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.
Kevin, M.D.
kevinmd_b
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Good Luck
Add a carrot for extra support too.
:)