Right abdominal pain w/ severe diarrhea; Weight loss; vision;

Sept'01 for 4 months, severe diarrhea, exhaustion, then dissipated. Returned for 3 months, then again dissipated. Chronic recurrant now, & are becoming more intense, lasting longer. ER visit Nov 1 '03; they were overloaded, but ASA they got vitals, put me in a room, gave IV's, and kept taking my vitals for 6 hours. The bottom BP number was 34. After that incident, didn't eat for 10 days, for fear's sake, lacked appetite, then I started eating only refried beans. Now I eat refried beans, Isomil and pur

[Kevin Pho, MD]

Hello - thanks for asking your question.

You note chronic diarrhea and bloating.  Fluctuating weight.  High cholesterol, fatigue, joint pain, hypothyroidism, difficulty swallowing food, pills.  

Let me address your GI concerns.  Your GI doctor is correct looking into Crohn's or malabsorption.  Other considerations would include chronic infection/parasite causing the diarrhea.  If you have a rheumatological disease (possible if you have hypothyroidism and a variety of joint symptoms), then celiac sprue may also be considered.  

Unfortunately, I would recommend endoscopy - either a flexible sigmoidoscopy or colonoscopy.  Stool tests for ova, parasites and culture should be performed.  Other tests to consider include an upper GI series or upper endoscopy (if you are having problems swallowing).  Tests for malabsorption (i.e. fecal fat) or for celiac sprue (via blood tests) may also be considered.  

Your symptoms are also consistent with posslbe rheumatological disorders.  I would also consider the opinion of a rheumatologist.  

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.

[PAJ]

See my posts below, As you see plenty of matches on symptoms

[cwilli2160]

I am writing out of concern for a friend of mine.  He had an appendectomy about 6-7 months ago and has been complaining of abdominal pain and diarrhea ever since.  His abdominal pain has progressed from only hurting when he lifted something to hurt all the time now.  He complains that he experiences diarrhea after every meal.  From my recollection his abdominal pain is in the right abdominal/pelvic region but I am not 100% certain.  He has visited an MD and had a hernia and scar adhesions ruled out.  He is very concerned that he might be developing Crohn's disease.  Is this a realistic concern?  Thank you.  cwilli2160

[cwilli2160]

I am writing out of concern for a friend of mine.  He had an appendectomy about 6-7 months ago and has been complaining of abdominal pain and diarrhea ever since.  His abdominal pain has progressed from only hurting when he lifted something to hurt all the time now.  He complains that he experiences diarrhea after every meal.  From my recollection his abdominal pain is in the right abdominal/pelvic region but I am not 100% certain.  He has visited an MD and had a hernia and scar adhesions ruled out.  He is very concerned that he might be developing Crohn's disease.  Is this a realistic concern?  Thank you.  cwilli2160