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Gastroenterology (Expert Forum)
HAVING A LOT OF GASTRO PROBLEMS, NOW HYPERTENSION FOR UNKNOWN CAUSE?
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.
HAVING A LOT OF GASTRO PROBLEMS, NOW HYPERTENSION FOR UNKNOWN CAUSE?
by HUMMING BIRD, Mar 09, 2003 12:00AM
HAD NISSEN WRAP AND HIATAL HERNIA SURGERY ONE AND HALF YRS AGO.
SINCE THEN,MORE AND MORE FOODS MAKE ME SICK AND HAVE DRY HEAVES.
DOESN'T MATTER WHAT KIND OF FOODS.LOST 58LBS.NOW, I HAVE NO APPETITE AND WHEN I MAKE MYSELF EAT SOMETHING, I CAN'T EAT MORE THAN A FEW BITES, I LIVE ON 2%MILK OR A PROTEIN SHAKE.
THEN THE BOWEL PROBLEMS STARTED.WOULD HAVE REGULAR EACH DAY,BUT THEY WOULD BE AND I'M EMBARASSED TO SAY,SMALL TO MEDIUM ROUND BALLS.OFF AND ON FOR THE LAST YEAR,THEY WOULD SOMETIMES HAVE MUCOUS ON THEM. THE GASTRO DOCTOR THAT I SEE, ASK ME WAS THERE ANY PAIN ASSOCIATED W/THIS AND I TOLD HIM NO,BECAUSE IT REALLY DOESN'T.
NOW, FOR THE LAST TWO WEEKS, ITS A LOT OF MUCOUS.A FEW DAYS AGO, I THOUGHT I HAD TO GO HAVE A BOWEL MOVEMENT.INSTEAD IT WAS WATER AND A BOWL FULL OF NOTHING BUT MUCOUS.WHEN I SIT SOMETIMES NOW I FEEL MY PANTS GET WET AND IT'S THE MUCOUS COMING OUT, LAST NIGHT IT HAD BLOOD ALL IN IT. AND INSIDE STOOL ITSELF,MUCOUS AND BLOOD WERE WRAPPED THROUGH AND THROUGH.
I HAVE NO PAIN WHAT SO EVER ASSOCIATED WITH THIS,BUT IN THE LAST FEW MONTHS MY BLOOD PRESSURE HAS GONE SKY HIGH,TO THE POINT I HAD A SMALL STROKE. AFTER I GOT OUT OF THE HOSPITAL W/NO USE OF MY LEFT ARM OR HAND. TESTS SHOWED A BRAIN BLEED, BUT THEY CAN'T FIND THE CAUSE OF THE HYPERTENSION. COULD THESE PROBLEMS I'M HAVING HAVE SOMETHING TO DO W/THE HIGH BP? AND WHAT IS YOUR OPINION ABOUT THESE GASTRO PROBLEMS? I HAD A COLONOSCOPY A YEAR AGO, ALONG W/UPPER AND LOWER G.I.SERIES AND ULTRA SOUND.THERE WAS NOTHING GOING ON THEN. I AM SO TIRED OF GOING TO DOCTOR'S FOR DIFFERENT PROBLEMS I HAVE, IT WOULD BE NICE TO HAVE THE OPINION OF ONE DOCTOR, WHO WON'T SEND ME TO A THOUSAND MORE SPECIALIST. I'M TIRED, AND TO THE POINT OF NOT WANTING TO TRY ANY MORE. JUST TAKE WHAT EVER COMES,(YES,I'M SEEING A PYSCH FOR MY DEPRESSSION)!!HOW CAN A PERSON KEEP TAKING ALL THIS? I GO INTO THE HOSPITAL TO HAVE SURGERY FOR MY GERD AND HERNIA,NOW ONE THING KEEPS LEADING TO ANOTHER IT SEEMS. I KNOW I WOULDN'T TRADE
MY LIFE FOR THE ONE PRIOR TO THE SURGERY, BUT ITS BAD BOTH WAYS JUST DIFFERENT. PLEASE HELP ME W/THIS W/O SUGGESTING ANYMORE DOCTORS,UNLESS THERE'S ONE DIFFERENT THAN MY GASTRO AND HE WAS SCHOOLED AT SOME OF THE BEST HOSPITALS AND I ALSO USE VANDERBILT AS WELL. ALL I NEED IS SOME SUGGESTIONS TO EMPOWER MYSELF SO I KNOW WHAT I'M DOING! THANK-YOU SO VERY MUCH DR.PHO FOR READING THIS AND HELPING ALL OF US THAT COME TO YOU IN NEED! GOD BLESS YOU AND YOURS.
SINCE THEN,MORE AND MORE FOODS MAKE ME SICK AND HAVE DRY HEAVES.
DOESN'T MATTER WHAT KIND OF FOODS.LOST 58LBS.NOW, I HAVE NO APPETITE AND WHEN I MAKE MYSELF EAT SOMETHING, I CAN'T EAT MORE THAN A FEW BITES, I LIVE ON 2%MILK OR A PROTEIN SHAKE.
THEN THE BOWEL PROBLEMS STARTED.WOULD HAVE REGULAR EACH DAY,BUT THEY WOULD BE AND I'M EMBARASSED TO SAY,SMALL TO MEDIUM ROUND BALLS.OFF AND ON FOR THE LAST YEAR,THEY WOULD SOMETIMES HAVE MUCOUS ON THEM. THE GASTRO DOCTOR THAT I SEE, ASK ME WAS THERE ANY PAIN ASSOCIATED W/THIS AND I TOLD HIM NO,BECAUSE IT REALLY DOESN'T.
NOW, FOR THE LAST TWO WEEKS, ITS A LOT OF MUCOUS.A FEW DAYS AGO, I THOUGHT I HAD TO GO HAVE A BOWEL MOVEMENT.INSTEAD IT WAS WATER AND A BOWL FULL OF NOTHING BUT MUCOUS.WHEN I SIT SOMETIMES NOW I FEEL MY PANTS GET WET AND IT'S THE MUCOUS COMING OUT, LAST NIGHT IT HAD BLOOD ALL IN IT. AND INSIDE STOOL ITSELF,MUCOUS AND BLOOD WERE WRAPPED THROUGH AND THROUGH.
I HAVE NO PAIN WHAT SO EVER ASSOCIATED WITH THIS,BUT IN THE LAST FEW MONTHS MY BLOOD PRESSURE HAS GONE SKY HIGH,TO THE POINT I HAD A SMALL STROKE. AFTER I GOT OUT OF THE HOSPITAL W/NO USE OF MY LEFT ARM OR HAND. TESTS SHOWED A BRAIN BLEED, BUT THEY CAN'T FIND THE CAUSE OF THE HYPERTENSION. COULD THESE PROBLEMS I'M HAVING HAVE SOMETHING TO DO W/THE HIGH BP? AND WHAT IS YOUR OPINION ABOUT THESE GASTRO PROBLEMS? I HAD A COLONOSCOPY A YEAR AGO, ALONG W/UPPER AND LOWER G.I.SERIES AND ULTRA SOUND.THERE WAS NOTHING GOING ON THEN. I AM SO TIRED OF GOING TO DOCTOR'S FOR DIFFERENT PROBLEMS I HAVE, IT WOULD BE NICE TO HAVE THE OPINION OF ONE DOCTOR, WHO WON'T SEND ME TO A THOUSAND MORE SPECIALIST. I'M TIRED, AND TO THE POINT OF NOT WANTING TO TRY ANY MORE. JUST TAKE WHAT EVER COMES,(YES,I'M SEEING A PYSCH FOR MY DEPRESSSION)!!HOW CAN A PERSON KEEP TAKING ALL THIS? I GO INTO THE HOSPITAL TO HAVE SURGERY FOR MY GERD AND HERNIA,NOW ONE THING KEEPS LEADING TO ANOTHER IT SEEMS. I KNOW I WOULDN'T TRADE
MY LIFE FOR THE ONE PRIOR TO THE SURGERY, BUT ITS BAD BOTH WAYS JUST DIFFERENT. PLEASE HELP ME W/THIS W/O SUGGESTING ANYMORE DOCTORS,UNLESS THERE'S ONE DIFFERENT THAN MY GASTRO AND HE WAS SCHOOLED AT SOME OF THE BEST HOSPITALS AND I ALSO USE VANDERBILT AS WELL. ALL I NEED IS SOME SUGGESTIONS TO EMPOWER MYSELF SO I KNOW WHAT I'M DOING! THANK-YOU SO VERY MUCH DR.PHO FOR READING THIS AND HELPING ALL OF US THAT COME TO YOU IN NEED! GOD BLESS YOU AND YOURS.
Doctor's Answer
by Kevin Pho, MD, Mar 09, 2003 12:00AM
, Mar 09, 2003 12:00AM
Hello - thanks for asking your question.
You have already been evaluated by physicians - please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only.
You are describing increasingly mucous-like stools, weight loss, and a normal (1 year ago) colonoscopy, upper and lower GI serious and ultrasound.
One consideration that you may want to suggest to your personal physician would be a malabsorption syndrome. The classic manifestations of global malabsorption are pale, greasy, voluminous, foul-smelling stools and weight loss despite adequate food intake. However, this spectrum of findings is relatively uncommon, even in generalized mucosal disease. The majority of patients with malabsorption have relatively mild gastrointestinal symptoms, which often mimic more common disorders such as irritable bowel syndrome. In some cases, anorexia, flatulence, abdominal distension and may be the only complaints suggesting malabsorption; other patients may be asymptomatic.
In many cases, the diagnosis of malabsorption begins with barium studies and/or endoscopy. You mentioned that these tests were normal 1 year ago.
Imaging of the pancreas by endoscopic retrograde cholangiopancreatography (ERCP) is helpful in the diagnosis of pancreatic insufficiency and may be critical for distinguishing benign from malignant causes.
A variety of tests can be used to detect malabsorption - you may want to discuss them with your personal physician:
1) Quantitative estimation of stool fat - The gold standard for diagnosis of steatorrhea (fatty stools).
2) 14C-triolein breath test - The test involves measurement of breath CO2 after ingestion of the radiolabeled triglyceride triolein, and provides a measure of fat absorption.
3) D-xylose test - This test measures the absorptive capacity of the proximal small intestine.
4) Lactose tolerance test
5) Breath tests using H2, 14CO2, or 13CO2 - These tests can be used to diagnose specific forms of carbohydrate malabsorption (eg, lactose and more rarely sucrose isomaltase and others).
6) Direct quantitative measurement of bacterial counts from aspirated intestinal fluid can be used to determine if bacterial overgrowth is causing your symptoms.
Followup with your personal physician is essential.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
You have already been evaluated by physicians - please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only.
You are describing increasingly mucous-like stools, weight loss, and a normal (1 year ago) colonoscopy, upper and lower GI serious and ultrasound.
One consideration that you may want to suggest to your personal physician would be a malabsorption syndrome. The classic manifestations of global malabsorption are pale, greasy, voluminous, foul-smelling stools and weight loss despite adequate food intake. However, this spectrum of findings is relatively uncommon, even in generalized mucosal disease. The majority of patients with malabsorption have relatively mild gastrointestinal symptoms, which often mimic more common disorders such as irritable bowel syndrome. In some cases, anorexia, flatulence, abdominal distension and may be the only complaints suggesting malabsorption; other patients may be asymptomatic.
In many cases, the diagnosis of malabsorption begins with barium studies and/or endoscopy. You mentioned that these tests were normal 1 year ago.
Imaging of the pancreas by endoscopic retrograde cholangiopancreatography (ERCP) is helpful in the diagnosis of pancreatic insufficiency and may be critical for distinguishing benign from malignant causes.
A variety of tests can be used to detect malabsorption - you may want to discuss them with your personal physician:
1) Quantitative estimation of stool fat - The gold standard for diagnosis of steatorrhea (fatty stools).
2) 14C-triolein breath test - The test involves measurement of breath CO2 after ingestion of the radiolabeled triglyceride triolein, and provides a measure of fat absorption.
3) D-xylose test - This test measures the absorptive capacity of the proximal small intestine.
4) Lactose tolerance test
5) Breath tests using H2, 14CO2, or 13CO2 - These tests can be used to diagnose specific forms of carbohydrate malabsorption (eg, lactose and more rarely sucrose isomaltase and others).
6) Direct quantitative measurement of bacterial counts from aspirated intestinal fluid can be used to determine if bacterial overgrowth is causing your symptoms.
Followup with your personal physician is essential.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
