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Gastroenterology (Expert Forum)
Follow-up of March 12
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Follow-up of March 12
by hudy, Mar 18, 2004 12:00AM
I am the woman, Hudy, who wrote the previous message on March 12. Thanks for the response. I have taken your advice, and with my husband, saw my physician. She is trying to arrange another colonoscopy.
But she said I should consider that I might have a "nervous" problem, since nothing "major" has read its ugly head since this all started. She has another patient who responded to Zyprexa, she said, and has suggested it for me.
I did research on Zyprexa and found it to be an antipsychotic. My husband is furious. He wonders at how, with not only bowel and esophageal problems, not to mention vaginal and anal ulcers, anyone could think the problem is in my head. Of course I am anxious about all this, who wouldn't be? However, I am a published author and have finished almost half of a novel, which is going well. I'm also a church organist. But a schizophrenic? Could you comment on this, please.
I have further questions, most of which arose from your response to me on March 13:
(1) Could stress cause the manometrically (and barium) diagnosed abnormalities in my esophagus (see previous message)?
(2) Could stress cause the bowel problems (see biopsy results in previous message)?
(3) Could stress cause vagingal and anal ulcers (see biopsy report)?
(4) What about stress and the recently diagnosed psoriasis?
(5) You suggest the possibility of Crohn's - don't past colonoscopies preclude a diagnosis of IBD?
(6) I mentioned that I have been keeping a symptom diary, to help me see if any food is causing problem. I have documented that one whole cup of milk or more causes major diarrhea and pain starting two hours after consumption. Yet, I had a lactose tolerance test recently which showed no lactose problem. Nevertheless, I am using lactase milk. However, the other day I reacted to that, again after two hours, and yesterday I reacted in the same way to cottage cheese. Could there be something other than lactose in milk that's causing the problem?
Thank you very much.
But she said I should consider that I might have a "nervous" problem, since nothing "major" has read its ugly head since this all started. She has another patient who responded to Zyprexa, she said, and has suggested it for me.
I did research on Zyprexa and found it to be an antipsychotic. My husband is furious. He wonders at how, with not only bowel and esophageal problems, not to mention vaginal and anal ulcers, anyone could think the problem is in my head. Of course I am anxious about all this, who wouldn't be? However, I am a published author and have finished almost half of a novel, which is going well. I'm also a church organist. But a schizophrenic? Could you comment on this, please.
I have further questions, most of which arose from your response to me on March 13:
(1) Could stress cause the manometrically (and barium) diagnosed abnormalities in my esophagus (see previous message)?
(2) Could stress cause the bowel problems (see biopsy results in previous message)?
(3) Could stress cause vagingal and anal ulcers (see biopsy report)?
(4) What about stress and the recently diagnosed psoriasis?
(5) You suggest the possibility of Crohn's - don't past colonoscopies preclude a diagnosis of IBD?
(6) I mentioned that I have been keeping a symptom diary, to help me see if any food is causing problem. I have documented that one whole cup of milk or more causes major diarrhea and pain starting two hours after consumption. Yet, I had a lactose tolerance test recently which showed no lactose problem. Nevertheless, I am using lactase milk. However, the other day I reacted to that, again after two hours, and yesterday I reacted in the same way to cottage cheese. Could there be something other than lactose in milk that's causing the problem?
Thank you very much.
Doctor's Answer
by Kevin Pho, MD, Mar 20, 2004 12:00AM
, Mar 20, 2004 12:00AM
To answer your questions:
1) It would be unlikely for stress to cause the findings on the barium swallow and manometry. A disease etiology would be more likely.
2) Stress may exacerbate the symptoms of irritable bowel syndrome. However, it is unlikely for stress to account for the inflammation seen on the biopsy.
3) It would be unlikely for stress to cause the ulcers.
4) It is possible to stress to exacerbate episodes of psoriasis.
5) Colonoscopies may not diagnose all cases of Crohn's. Usually a small bowel series and/or antibody studies are used in conjunction.
6) You may want to consider the lactose breath hydrogen test to evaluate for intolerance. It is a more sensitive test than the lactose tolerance test.
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.
1) It would be unlikely for stress to cause the findings on the barium swallow and manometry. A disease etiology would be more likely.
2) Stress may exacerbate the symptoms of irritable bowel syndrome. However, it is unlikely for stress to account for the inflammation seen on the biopsy.
3) It would be unlikely for stress to cause the ulcers.
4) It is possible to stress to exacerbate episodes of psoriasis.
5) Colonoscopies may not diagnose all cases of Crohn's. Usually a small bowel series and/or antibody studies are used in conjunction.
6) You may want to consider the lactose breath hydrogen test to evaluate for intolerance. It is a more sensitive test than the lactose tolerance test.
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.
