I am a 20 year old male, athletic build with sinusitis being only past medical history. There is a lot of cancer on my father’s side of the family but none on my mothers.
During the summer, I started to develop stabbing abdominal cramps followed by mustard-yellow colored explosive diarrhea. The diarrhea was abnormally foul smelling, it floated, and seemed really acidic. When I wiped, the toilet paper would look almost neon yellow. Two to three times a week for the three month summer vacation, I would have this yellow diarrhea. I figured that the yellow color was just stomach acid and nothing to worry about. In late August, when I returned to college, I started to get this diarrhea consistently for a full two weeks that was accompanied by lower right quadrant abdominal pain along with lower right back pain, night sweats, weight loss, chills, and thirst increase. When I eventually reached out for help in early September I was rushed to the E.R. for a possible appendicitis. The CT Scan in the E.R. showed that I had borderline appendicitis due to the appendicitis not filling with the contrast fully and the mesenteric lymph nodes of the area being “shoddy”. I was given Cipro and Flagyl for two weeks to see if that would fight the infection. After an ultrasound, they found my appendix healed completely. While the yellow explosive diarrhea has returned to coming 2-3 times/week (rather than the daily occurances) the pain in my lower right abdomen and back continued at the same intensity. Meanwhile, I started to lose weight rapidly.
After a colonoscopy showing inflamed nodularity in the terminal illeum, an endoscopy showing “abnormal” results(definitely non-cancerous) in my upper small intestine and signs of GERD, another CT scan showing a thickened terminal ileum, and another six weeks of Cipro for a cured prostatitis, my gastroenterologist seems stumped. He has tested my adrenals and for any sign of infection-No Luck. He wonders about Crohn’s Disease but has no true evidence and truly doubts that Crohn’s Disease with this little amount of evidence could be causing these extreme symptoms. Since this is my second opinion doctor, I have another Colonoscopy AND Endoscopy on Wednesday so he can clarify those “abnormal” results and so he could look at my colon and ileum himself. Meanwhile, he is also doing a stool fat test that should have results by tomorrow.
By November I had lost 25 lbs so I started to eat much more than normal yet I still am not gaining weight (yet I am not loosing anymore weight). I am the most exhausted I have ever been in my life and these four months since September have truly been torturous. With my family history, I wonder about cancer of the pancreas, endocrine system, small intestine and lymphoma/leaukemia. Yet, I feel that something would have showed up by now. My family and friends are very worried about me and I am truly worried about dying. I am deteriorating. Please help
Welcome to the gastroenterology community! You can't cure an appendicitis with antibiotics. With your CT's since then being normal in that sense, it was likely that you never had any problem with your appendicitis. Also, if the doctors thought you had an appendicitis, they would most likely do surgery (it is only is rare cases that they give you antibiotics and then a week or so later do surgery). It sounds like you are getting a lot of antibiotics from doctors that don't really know what is going on. I would recommend you talk to your doctor about starting on a probiotic. Unless there is one type of cancer that is common in your family history, it is unlikely that your family history of cancer has anything to do with this. I would recommend that you also consider seeing a therapist about your worries about dying, as this is not normal.
Thank you very much for your response. The first CT scan indicated
"the distal appendix is bordeline prominent diameter, 6mm and does not fill with oral contrast. These findings are equivocal for appendicitis. Shoddy right lower quadrant mesenteric lymph nodeds noted."
yet the surgeon didnt think it was SEVERE enough to operate. then the ultrasound (after the Cipro and Flagyl) says
"The appendix is seen in the right lower quadrant, measures no more than 3 mm in thickness, is not hypervascular, and appears compresable. No sonographic findings specific for appendicitis."
I wil definitely adress the probiotic idea.
I mispoke when I said "I am truly worried about dying". I just feel run down and I am the skinniest I have been in at least five years. The pain is uncomprehensible and I am just desperate for an answer. I may have been a little dramatic at the time when I posted last. Sorry!
If you had an appendicitis, you would have had an operation. The "severity" of an appendicitis doesn't change whether or not you would operate. What the results of your first CT scan probably mean, is that you had this incidental finding, and you never had any problem with your appendix in the first place. Anyways, that is in the past. However, antiobiotics kill off the good bacteria in your gut which can cause problems, which is why I recommend a probiotic. Also, have you noticed any correlation with your symptoms to anything you ate?
Yellow stool, abdominal cramps & diarrhea are signs of giardiasis. You could have caught it on holiday from contaminated food/water (drinking but also swimming in a lake etc), contact with animals, or even kids - they get all kinds of stuff at kindergarten cause they put their fingers in their mouth a lot.
Have your stool checked for giardia. One time might not be enough - it has a certain life cycle and is not always present in stool at the right time. To increase chances of proper diagnosis look for a lab that tests more than one sample at once (for example collected on Monday,Wed,Frid).
To patient915, thank you for your wisdom but I have no correlation with symptoms and something I've eaten. I have avoided dairy for a week (twice as long as recommended by three M.D.'s) and no luck. And I have done the same for wheat products as well as being tested for Celiac through blood tests and biopsy tests of my upper GI tract.
Thank you very much for all of the info soolo. I am actually in the process right now of doing those Giardia tests. The Cipro/Flagyl have been given to me for these "repeated infections" of the appendix and prostate, yet both have been cured and the symptoms still persist.
Could these repeated infections (including the chronic sinusitis I've had for four-five years) be a sign of anything?
Also what could be an issue with gallbladder/bile duct that wouldn't show up on the CT scans?
I really appreaciate more than I can express.
Tomtom, if your doc is considering the possibility of some form of inflammatory bowel disease, there is a blood test that might possibly help sort that out. With IBD's, sub-clinical levels can often be found many years before the actual problem rises to the clinical stage. A test such as Serology 7 might help to check out that parameter. Keep in mind though, that no tests are 100 percent perfect.
Is there any history of celiac in your family? If so, and if the tests you did for celiac were blood tests and didn't include the full panel - some docs will only check the transglutaminase levels and that's not enough - have it redone testing IgA/IgG gliadin and total IgA. If the IgA and IgG are still negative, but the total IgA levels are low, recheck again doing a fecal antibody test you can get through enterolab.com. It's a great test that hast pinpointed the problem when a lot of other tests have failed.
In some, the presence of gallbaldder dysfunction can result in explosive, yellowy diarrhea, upper right quadrant and floating stools. And a way to check for gallbladder issues should include a gallbladder ultrasound and HIDA scan with CCK injection.
In the blood tests that were done, were your amylase and lipase levels checked?
Wow, thank you very much for all of your suggestions. I will make sure to forward this information to my doctor. I have been checked for Celiac and the tests were all negative-plus I have no family history of the disease.The gallbaldder dysfuntion along with the Serology 7 tests very much interest me. I will highlight those too my doctor. I do not think my amylase and lipase levels were checked-what do those do?!
I just got off the phone from my doctor who just told me that the endoscopy came up with "holes" in the duodenum yet the biopsy was tested for all diseases the in-house pathologist could think of. Also, the colonoscopy came back with many ulcers in my illeum. With the thickening of the illeum from my last CT, the colonoscopy results, and the symptoms I had, the doctor was ready to diagnose me with Crohns. Still, he wanted to be sure so he order a capsule endoscopy for me. The capsule came back negative, however the capsule went through the illeum too quickly to get a good look. Still, the rest of my small intestine looked fine. Therefore, he is not willing to diagnose me with Crohns. Soooooooo now back to the drawing board. I am going to suggest a "trial" with Crohns medications while I am getting tested by many of the tests you listed above. Thank you again for all of your help. I will make sure to adress all that I can.
Thank you and God bless.
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