Re: Recurrant symptoms

6 years ago I started having bad stomach upsets characterised by loose stools, nausea, lower abdominal pain & fatigue. The Dr couldn't find anything wrong so sent me home. I gradually became iller as the upsets continued over 3-6 months I ended up in bed with fatigue, weakness and malaise. I then saw a different Dr who suggested I might have Giardia. After flagl I felt better and started to recover only to have a reoccurance of symptoms 6 months then 12 months later. Each time flagyl fixed me. On the 4th reoccurance (sickness, loose stools, gasteorentirius, nausea, weakness, fatigue)I had an endescope and colonoscope where they found I have focal accute colitus of no known cause & also slush in my gall bladder. A course of antibiotics fixed me and repeat colonoscopy showed the infection had gone.

When I relapsed the next time they took a different approach and  treated me as if I had an inflamatory condition. I felt somewhat better from anti inflamatories such as olsalazine but it was really antibiotics that made my stools normal again, stopped the nausea and gave me my energy back. I had various scans such as MRI, CT, Ultra sound, barium meal and everything was normal apart from again slush in the gall bladder on all occasions. In 2003 after 3 years of illness I finally got back into full time work.

As things progressed over the last 2 years I have generally got much better but I now expereince attacks every 2-3 months of nausea, fatigue, headachyness, weakness, and sometimes a bad stomach but not really anything severe. I do get lower right abdominal pain and I also go yellow (bilirubin 4 x normal) however this has been put have down to Gilberts. Whenever I have  been ill in the last 2 years blood test results show (high bilirubin, high iron & iron saturation, a low lymprocyte count and a slightly elevated MPV). In between attacks blood is normal and I feel totally normal. When I have these attacks I often feel infected so am usually given antibiotics as Dr can find no explanation. After 1 day of antibitics I feel much better and am totally recovered after 3-4 days of a course. I have had everything from cipro - oxfloxacin - cephradine - flagyl - doxycycline. Sometimes one doesn't work so we revert to the next one. I have also been presecribed Mepacrine in the past once when various antibiotics failed.

The problem is I have seen the a Prof of immunology in London who said no hiv & there's no infection or anything wrong with my immune system. I have done 30 + stools tests over the years with all negative results. I have also seen gastenterologists who have never seen elevated esr or crps so say it can't be inflamatory and hepatologists say there is no liver problem or the hemacromatosis gene. A homeopath has suggested it is blasto cystis homonis or a recurrant parasitic infection.

I was just wondering if anyone had any thoughs? Also where is the best hospital for gasto in the US, Mayo clinic?

Male 28: drug, family, alchol history -ve

[Kevin Pho, MD]

This sounds like a difficult case.  

You clearly have been through a comprehensive, appropriate evaluation with various endoscopies and scans.  The stool tests are appropriate - you can also test for lactoferrin to see whether the loose bowel movements are due to inflammation or not.  

If the symptoms react to antibiotics - colitis continues to be possible.  A biopsy via the endoscopy can be repeated for a more comprehensive diagnosis.  

Blastocystis hominis is an unlikely cause.  This parasite is typically not the cause of severe diarrhea, and normally observed and not treated.

If every test is negative, irritable bowel syndrome can be considered.  Treatment can be optimized using antispasmodic agents.

Any major academic medical facility in the US would have a strong GI department.  The Mayo Clinic is a fine choice.  

These considerations 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_

[yoshi]

I am surprised they dont test you for hector pylori bacteria ,it is a simple breath test done in doc's office??

[mcyiide2]

I have asked for that test before and only had an anti body blood test as I was told that test was not avalaible in the UK?

[PAJ]

The success of the  antibiotics would seem to indicate an infection , the tests showing nothing is no surprise

[shelmeg]

I also had some of the same symtoms (symptoms) as you did.It seem like would get real weak and tired 3 to 5 days before i would get realy bad stomach promlems that would last for a few days.It would only happen every three or four months at first, then here lately it has it me three times in two months.It took 10 days to get over the last one.Its been happing for about four years.To many doc vistits to count,they told me IBS at the docs and hostpital until i had a blood work done and my liver enzymes were 190, so we dont know if that is the problem or not yet.Will let you know.

[wildu2]

I also have experienced similar symptoms for more years than I can remember (about 10). The DR's put me on anitbiotics which makes the symptoms go away and any infection clears up. The drug that works for me is Noroxin. Once I complete the course the symptoms return in a few months and I am back at the DR's. More recently I have taken URAL which seems to keep things in check but once I stop the pains return. In my case the stomach pains and diaherra (diarrhea) have been minimal ... it is more lower adominal (abdominal) pain, burning sensation when urinating and urgency to go. To date I have been diagnosed as chronic prostatitis. Someone recently suggested cystitis.

Back to the urologist in a couple of weeks will update this thread.

Male: 37 ... Melbourne, Australia ... go the Socceroos!