Constant nausea after eating, stomach pain, headaches, unwell-feeling, need alternative diagnosis

[Oglegen]

Travel in India 2 yrs ago, rescued a diseased dog. Had diarrhea, vomiting, stomach cramps. Took ciprofloxacin, 2x 250mg per day for 5 days. Diarrhea subsided but nausea + stomach pain continued. On return have had 6 parasite tests - Aeromonas Hydrophilia found, but ciprofloxacin taken.  No other parasites. Symptoms are worse over 2 years.

Symptoms:

- Constant nausea 20 mins after eating, worse in evening, and vomiting if no anti-emetics taken.
- Burning pain in centre of abdomen (around navel), worse at night
- Severe stomach cramps, upper and lower right side of abdomen, most days
- Excess wind with sulphuric smell
- Daily bloating and distension
- Once a week wake up in early hours (4am,5am) with feeling of low blood sugar, dizziness, headache, vomiting and diarrhea.
- Always undigested food in stools which smell like vomit
- Heart palpitations, mainly in morning
- Pain in lower abdomen during sexual intercourse, makes stomach distended and painful
- Feel better upon lying down and much worse when standing/sitting up/moving around
- During nausea and pain attack, urine becomes cloudy+ filled with a layer of thick, solid white particles.
- Menstrual periods have stopped
- Daily migraines starting in afternoon
- 1 stone weight loss.

Tests been done:

Endoscope (1 yr ago) - stomach inflammed
Colonoscopy (1 yr ago) - normal
Abdominal Ultrasound (1 yr ago) - normal
H. pylori - negative
Liver function - normal
Kidney Function - normal
Thyroid function - slightly high
Pelvic Ultrasound - normal

Antibiotics:
Ciprofloxacin twice, metronidazole once, with no improvement

Daily meds:
Compazine, metoclopramide, domperidone, pain killers

Questions:

What else do you think this could be?
What other tests can I ask my GI Doctor to do?
Is there a chance that it is a virus which can only be identified during flare-ups?
My partner (who travelled to India too) presented bloating, nausea and stomach pain 6 months ago. Is it likely they are related?

[Kevin Pho, MD]

I can't comment on what it could be without examination.

You have had a variety of tests that would have excluded major GI causes.  The bloating and undigested food can be due to delayed gastric emptying, which can be evaluated with a gastric emptying scan.

Celiac disease and malabsorption are other possibilities, and can be excluded with blood tests.

Otherwise, treatment for irritable bowel disease can be optimized by antispasmodic agents or increasing the amount of fiber in the diet.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[lizziecee]

Until Dr Pho responds, thought I would tell you of an unusual disease I caught from an elderly dog left outside our villa when we lived in Spain in 1991.  I had various symptoms, the worst being foul smelling gas and faeces along with severe diarrhes and a greenish discharge from my vagina.  As I have Crohn's, I thought this was the reason. I went to see various doctors in Spain and eventually the gastro there said I should return to England and my previous hospital for evaluation of a fistula between my anus and vagina. I had lots of tests, including a whole body scan, nothing found.  Saw a gastro, a gynaegologist and no-one could sort it out. Even after a shower I smelt terrible, and it ended our sex life.

Eventually, after 4 visits to England, my gastro sent me to see an elderly physician at the hospital (a large teaching hospital in London) and he said "Just tell me the story from the beginning...". I don't know why I mentioned this elderly dog, whom I fed each morning (husband never did it) which we had to have put to sleep for Leishmaniosis. Something clicked with the dr, and he took a swab of the foul discharge and sent it to the Hospital for Tropical Diseases in London. Result - I had Leishmaniasis - the human form which is also called Spanish Sand Fly disease. He said because I have an auto-immune disease (Crohn's) I was suspectible. Leishmaniosis is found in animals in tropical countries (such as India and sub-tropical countries like Southern Spain).  I was prescribed a specific antibiotic (sorry, can't remember what it was, as it was 17 yrs ago), which made me very sick for 3 days, but it did cure the problem. We returned to live in England soon after, and I have not had it again thankfully.

I could be clutching at straws here, but if you haven't been tested for this parasite, it may be worth mentioning to your drs.

Hope Dr Pho has some constructive advice - he is wonderful.

Take care,
Liz.

[Oglegen]

Liz this is very interesting because the dog had green sores and marks around its belly and genital area. I will definitely mention this to my doctor. Did you have any nausea or vomiting with your symptoms?

[lizziecee]

Hi - yes, I had such bad nausea and vomiting, I just used to push my food around the plate when eating out with friends. I lost some 28 lbs before I was properly dx. I don't recall seeing any sores on the dog, but she was blind, deaf and had a cancerous tumour, so the vet we took her to said it would be a kindness to put her to sleep. The vet told me the dog had Leishmaniosis. Makes me wonder if I am a "white witch"....what on earth prompted me to tell the physician about the dog? Well, will never know, but glad I did.

Hope you get a proper diagnosis soon - let me know how you get on please.
Liz.