5 yrs. dx unknown!!

[dna200469]

I have had problems for about 5 yrs now. It started out with alternating constipation and diarrhea. After the first colonoscopy and M.D. he diagnosed me with crhon's disease and removed some polyps (benign). 2ND colonoscopy (same M.D.) dx was chronic colitis. Needless to say, the next M.D./colonoscopy, it was IBS. I heard about an M.D. that was very good so I gave it a shot!! I ended up with 3 surgery's at one time, cholecystomy, acid reflux, and hietal hernia repair. That was in August of 2003. Now after I eat, regardless of what it is, it hits me always at the wrong time. I work for hospice home health and I am on the road all day. I have to take appetite suppressants all day so I won't get hungry, and have an extra change of clothes with me at all times!! When I finally do break down and eat, it takes me about 2 hrs to get over it. Well, this M.D. is mostly upper GI and he referrs me to a specialist (lower GI) that is approx 50 miles away from me. He does a colonoscopy and all results are clear no dx. He prescribes me a pill to take 30 mins before I eat sometimes it works and sometimes nada. I have tried the prevalite,metamucil, etc. When it does work I'm constipated for about 3 or 4 days then when it finally hits me...OH MY GOD!! The pain is so bad throughout my intestines, I break out into a pouring sweat, gag (and sometimes throw up) and I have almost passed out a couple of times. I have extremely hyperactive bowl sounds in all four quadrants, in fact you don't even need a stethscope to hear it, it is that loud! I can't take anymore of this. My body is so weak and I never miss a days work. I was hospitalized June of 2004 for dehydration. Go figure! I think the multivitamins are whats keeping me going. Please help! I go back to the M.D. Wed.10*19*2005 and I am already prepared for the agonizing test ahead of me!!

Thanks in advance :)

dna200469

[Kevin Pho, MD]

It will be difficult to say exactly what is going on without examination.

You have clearly been through a comprehensive evaluation with multiple colonoscopies and surgeries.  

With a non-revealing colonoscopy (most recently) - irritable bowel certainly can be considered.  Other options would be malabsorption - which can be either fat malabsorption or celiac disease.  Obtaining stool studies to evaluate for the former, or blood antibody testing for the letter disease, is reasonable.  

If irritable bowel disease is the diagnosis, you may want to consider optimizing treatment.  This can include anti-spasmodic agents as well as Zelnorm (if the IBS is constipation-predominant).

These options can be discussed with your gastroenterologist.

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.
http://www.straightfromthedoc.com

[sick for 22 years]

Please get your thyroid checked, and also ask your doctor to test you for celiac disease. Please see my earlier threads below, like the ones to alleyoop, NYreflux, and HAVE YOU CHECKED YOUR THYROID .  I also suffered nausea, vomiting,constipation, and excruciating abdominal pain because of untreated hypothyroidism. The medical tests and procedures I was put through could fill twenty college textbooks.I also got what I thought were "shakes" from the pain, but what it was was actual shivering because my body couldn`t keep itself warm anymore.Please write and tell us what you find out.

[ArmourGal]

I'll just second the recommendation to get your thyroid checked...and not just TSH, also thyroid antibodies and the Free levels, Free T4 and Free T3.  

About 10 years ago i started having digestive ailment similar to yours and all the gasterontologist said was IBS.  A second trip about 5 years ago and they said the same.  Come to find out I have Hashimoto's/hypothyroidism.  It's taken over a year of treatment for my digestive system to get back some type of normalcy because it was so damaged by the hypo.  I can't believe gasterontologists don't check for this, as my story is not uncommon at all according to the folks I've met on thyroid forums.  I'd bet a good 1/3 of them have had IBS diagnoses.