Long term diarrhoea and now gastritis

[Peasle]

I am 32 year old female, who has had diarrhoea since 1996.  It seemed to begin when I was given Prozac for panic disorder in 1996.  I currently take Sertraline.  I know stomach problems can be a side effect of SSRIs.  I have never had a very strong stomach regardless, and my father and sister have similar problems.

I have also found that certain foods trigger episodes - onion, tomatoes, mayonnaise, soya, wholemeal bread, garlic, oily foods.

The symptoms seem to worsening.  I have diarrhoea around 4-5 days a week.  I get a 20 second 'abdominal cramp' warning - and several times have not been able to reach a toilet. I also now have gastritis symptoms fairly regularly: burping, acid pain, left side pain under rib cage, flatulence, throat burning after taking my tablets, lots of nausea.  This is definitely worse after drinking alcohol (which I rarely do) and fatty foods. I smoke, and have taken lots of over the counter anti-inflammatories for headaches in the past.  At first, I thought the gastritis was a recurring stomach virus or food poisoning - until I mentioned it to my doctor, and he suggested gastritis.

Occasionally, I also have very pale stools.  This tends to be after I have taken anti-diarrhoeal medications, or when I have eaten lots of fatty foods.

I told my GP that I feel the SSRI is causing the problems.  He has suggested I taper and we revisit the situation - however, that is causing me to have panic attacks.  He mentioned I could have my stools tested for helicobacter pylori.

Although he has mentioned having other tests in the past - such as an colposcopy - I think he doesn't feel it is necessary, and thinks it is probably IBS. I don't have blood in my stools, and I haven't lost any weight. (I am 9 stone 5 - as the SSRI has made me put on a stone in weight).  My sister had all the tests - and was diagnosed with IBS - and I know they aren't very pleasant tests! (She was sent for the tests immediately - whereas my symptoms have been going on for 10 years, so I presume the GP doesn't think it is anything sinister). My doctor suggests I use Imodium for the diarrhoea, and Zantac for the gastritis.

I would just be interested to hear your thoughts on my symptoms - especially the diarrhoea/pale stools.  Also are there any non-invasive tests that might give an indicator of what is wrong?  I'm fed up of feeling ill all the time!  Do you think it is most likely just a side effect of the SSRI?

Many thanks

[tmj864]

To go along with the post I did earlier. I had an upper GI in 2005 no problem. In 2006 Upper GI diagnoised with gastritis possibly H.pylori(Wating on results now). I had a colonoscopy in 2005 that diagnoised the Hemorrahgic colitis. Had a CT scan this year (2006)w/no problems with kidneys, pancrist,liver, and other things that go with an abdoment scan.

[tmj864]

When I was young my guardian put me on Prozac and then Paxil. They kept increasing my dosage even after telling to horrible side-effects I was having. In 2000 I stop taking the Paxil. In 2002 I was diagnoised with Fibrocystic Breast disease. In 2005 I was diagnoised with Hemorraghic Colitis(bloody diarrhea/with horrible pain). In 2006 I was diagnoised with Gastritis(horrible abdominal pain/with vomiting,and diarrhea). Also my doctor just found 1percent traces of blood in my urine. All of this and I just turned 24. Are all of these disease associated with the Prozac or Paxil? Can you explain what blood in urine mean?

Thank you Terri

[myproblem]

Sertraline did not seem to make me worse, although my symptomshave worsened gradually over the past year. I am still waiting for results.

[Kevin Pho, MD]

I would suggest a colonoscopy to further evaluate the diarrhea.  This can evaluate for inflammatory bowel disease as well as other major lower GI disorders.  

Other causes to consider would be various types of infection or malabsorption syndromes.  Sending the stool off for culture and analysis would evaluate for infection.  You can also send the stool off for various fat malabsorption syndromes.  Blood tests can be done to look for celiac disease.

It is also possible that the GI effects can stem from the SSRI - changing to another antidepressant can be considered.  

If the tests continue to be negative, optimizing treatment for IBS can be considered.

Pale stools should trigger an evaluation of the gallbladder and biliary ducts.  An abdominal ultrasound can be considered.

These options can be discussed with your personal physician.

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

[Peasle]

Thanks for your message.  I'd be interested to hear your results.  Did you find your symptoms worsened when you started taking the Sertraline?

Also - just realised I wrote colposcopy.  I meant colonoscopy!!

[AfricanGrey]

I would concentrate your efforts to quit smoking.  Smoking exaserbates all of those symptoms you describe.  I had similar symptoms and the first thing my doctor told me is that smoking increases and worsens the symptoms.

[myproblem]

Have you tried Nulev yet? It is a smooth muscle relaxant, and works in 15 minutes. It works for me sometimes, but other times I have to run to the bathroom anyway. Our symptoms sound very much alike. I am in the process of diagnosis myself, and if I find out anything useful, I'll post. I also take Sertraline 50mg. at night, but these symptoms were present before that.