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Gastroenterology (Expert Forum)
Malabsorption? IBS? Strange symptoms..
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.
Malabsorption? IBS? Strange symptoms..
by jlee06, Jun 17, 2006 12:00AM
Hello I am M/24
Not sure where to get started. But for the past year and a half I've been going through bouts of diahrea/loose stool that usually lasts for 2-3 days. I experienced these bouts about 1-2 times a month. I went to see my doctor and he said it was fine and normal and to watch my diet, etc. About 5 weeks ago I came down with a fever one night and had constant diahrea. The fever subsided the next day but I had constant diahrea for 3-4 more days. I took a pill of imodium (immodium) which kept me constipated for a day. On the 5th day I woke up with my stomach/abdomen area strangely fatigued and sore. I thought this was usual and resumed my daily activity. I noticed that day that there was undigested food in my stool and it was partly floating. That same night while in bed I noticed that when I'm lying down with my stomach facing up I feel a strange sensation..like there was pressure pushing down on my stomach. I woke up about 4 hours later during the night to hear my intestines rumbling and it creating gas. I realized that when i stand up the rumbling would stop but as soon as I lie down with my stomach facing up it would start again.
This happenend for 3 straight days so I went to see my physician. He prescribed levaquin and metronidazol which I took for 5 days with no results. I also had various blood tests done and he said everything looked normal. He referred me to a GI Dr and we scheduled a colonoscopy/endoscopy.
The GI specialist gave me protonix to take for a week which again had no results. During the colon/endo he found that I had gastritis/duodentitis, a spastic colon and a strange finding - esophagitis candida. I had tested negative for HIV just a week ago so he ruled that out. He said the candida might be due to taking antibiotics for 5 days (my physician find that very interesting how taking antibiotics for 5 days can cause candida in the esophagus). I tested negative for parasites, and the biopsy report came back negative on many gi diseases as well as H. Pylori however it did reaffirm that i had esophagitis candida. Both doctors stated that the candida has nothing to do w/ my stomach problems. The GI specialist told me to do another endo to see if my candida subsides in a month. He put me on diflucan for 2 weeks and told me to continue taking protonix as well as telling me to take OTC florastor.
It has been 10 days since then and I am still having the same symptoms. Undigested/Floating/sometimes loose/sometimes large pellet/ stools. Still feeling strange pressue when i lie down. However I find that if I sleep with my stomach facing the bed my stomach would stop making noises and cause me less discomfort. I am also losing weight. I lost about 8-9 pounds since last month and have been unable to gain it back. Other symptoms like muscle twitching have started to appear and also I'm experiencing slight weakness/pain in the soft area of my leg behind my kneecap.
Are the Dr.s missing anything? Any reccomdentations? Thanks..
Not sure where to get started. But for the past year and a half I've been going through bouts of diahrea/loose stool that usually lasts for 2-3 days. I experienced these bouts about 1-2 times a month. I went to see my doctor and he said it was fine and normal and to watch my diet, etc. About 5 weeks ago I came down with a fever one night and had constant diahrea. The fever subsided the next day but I had constant diahrea for 3-4 more days. I took a pill of imodium (immodium) which kept me constipated for a day. On the 5th day I woke up with my stomach/abdomen area strangely fatigued and sore. I thought this was usual and resumed my daily activity. I noticed that day that there was undigested food in my stool and it was partly floating. That same night while in bed I noticed that when I'm lying down with my stomach facing up I feel a strange sensation..like there was pressure pushing down on my stomach. I woke up about 4 hours later during the night to hear my intestines rumbling and it creating gas. I realized that when i stand up the rumbling would stop but as soon as I lie down with my stomach facing up it would start again.
This happenend for 3 straight days so I went to see my physician. He prescribed levaquin and metronidazol which I took for 5 days with no results. I also had various blood tests done and he said everything looked normal. He referred me to a GI Dr and we scheduled a colonoscopy/endoscopy.
The GI specialist gave me protonix to take for a week which again had no results. During the colon/endo he found that I had gastritis/duodentitis, a spastic colon and a strange finding - esophagitis candida. I had tested negative for HIV just a week ago so he ruled that out. He said the candida might be due to taking antibiotics for 5 days (my physician find that very interesting how taking antibiotics for 5 days can cause candida in the esophagus). I tested negative for parasites, and the biopsy report came back negative on many gi diseases as well as H. Pylori however it did reaffirm that i had esophagitis candida. Both doctors stated that the candida has nothing to do w/ my stomach problems. The GI specialist told me to do another endo to see if my candida subsides in a month. He put me on diflucan for 2 weeks and told me to continue taking protonix as well as telling me to take OTC florastor.
It has been 10 days since then and I am still having the same symptoms. Undigested/Floating/sometimes loose/sometimes large pellet/ stools. Still feeling strange pressue when i lie down. However I find that if I sleep with my stomach facing the bed my stomach would stop making noises and cause me less discomfort. I am also losing weight. I lost about 8-9 pounds since last month and have been unable to gain it back. Other symptoms like muscle twitching have started to appear and also I'm experiencing slight weakness/pain in the soft area of my leg behind my kneecap.
Are the Dr.s missing anything? Any reccomdentations? Thanks..
Doctor's Answer
by Kevin Pho, MD, Jun 19, 2006 12:00AM
, Jun 19, 2006 12:00AM
You have had a pretty comprehensive evaluation for your symptoms.
One option would be sending the stool off to the lab for tests on malabsorption.
Candida esophagitis normally occurs in cases of immunosupression. I agree with the HIV testing. However, a referral to an immunologist many not be a bad idea to ensure there are no other rare diseases of immunosupression present (i.e. common variable immunodeficiency etc.).
Another consideration would be something like celiac disease - which can be tested via a blood antibody test.
The pain behind the kneecap should be evaluated for clot - via a doppler ultrasound.
These options can be discussed with your personal physician.
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.
kevinmd_
One option would be sending the stool off to the lab for tests on malabsorption.
Candida esophagitis normally occurs in cases of immunosupression. I agree with the HIV testing. However, a referral to an immunologist many not be a bad idea to ensure there are no other rare diseases of immunosupression present (i.e. common variable immunodeficiency etc.).
Another consideration would be something like celiac disease - which can be tested via a blood antibody test.
The pain behind the kneecap should be evaluated for clot - via a doppler ultrasound.
These options can be discussed with your personal physician.
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.
kevinmd_
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Sorry for the long post.. Just wanted to see if you could suggest anything as my symptoms haven't lessened. Thanks again
Protonix,Nexium,Prilosec,Zantac of the world reduce stomach acid and allow bacteria to grow.
Can you wait till you are done with Diflucan to take Protonix?
You can watch your diet carefully by avoiding food and beverage which irritate your stomach,in other words you need to 'baby' your stomach,food which is safe like plain boil rice,white bread/toast,water,boil potato,steam fish etc all that boring stuff.
Chewing gum will make your mouth produce more saliva which contains bicarbonate and it will neutralise gas in your body,so will baking soda ,alka seltzer and OTC GAS-X.
Drinking lots of water is also good for your stomach and the rest of your body.
Dr Crantons treatment protocol http://drcranton.com/CFIDS.htm#CFIDS%20Paper
http://www.yeast-candida-infections-uk.co.uk/
Great website !