Still no answer-please help

[jfem]

I'm 40 yo female, no med or surg hx. 5'7 155 pounds, eat well, exercise 4-5 X/per week 45-60 minutes.
11/28 levaquin for presumed sinus infection. Day 3 of meds, begin w/yellow stools 2-3 X/day. Stopped Levaquin

12/3 started with nausea/abd pain/yellow stool, no appetite.
Exam negative, abd soft.
Tried Prilosec, then Zantac, then Pepcid. Upper abdominal pain stopped, nausea stopped. Stopped meds.

Feeling like there is a brick in my stomach continued.
Endoscopy 12/20 revealed very mild gastritis. MD didn't feel it was causing the symptoms.
Stools all negative.
Blood work negaive -only A/G ratio was 2.2 can carbon dioxide was 19.celiac comp panel-negative
Gliadin Antibody IgA negative
IgA neg.

had a week of pfeeling 100% normal ( 1/1-1/11) then the "brick" came back, and the appetite button was shut off again.

Still continues, although my appetite comes and goes throughout the day and I just force myself to eat small frequent, light meals so I have energy  ( mom of 4)

Stools are soft, but formed, usually once a day, and mostly brown. Then there are days that my stomach has that "diarrhea" noise, and feel, and the next day I wake up to loose yellow stool and will have it once or twice that day.
The next day, it could be back to formed brown etc...

I am at my wits end with this.
I had a CA 125 test, and gyn exam last week-both negative.I have a vaginal US to r/o ovarian cancer tomorrow, and I have an abdominal US Thursday to check my gallbladder.

Where else do I turn?
Is it still GI? Should I get a CT scan? HIDA scan?
Any thoughts??
Thanks,J

[jfem]

I have been checked for C diff and it was negative.

The yellow stool is not every day, just 2- times/week, mostly it's just very soft brown stool...not had a formed one in about a month.

I'm having a gallbladder US Thursday, will that tell anything?

Thanks for your responses...

[Mom82207]

If all others are ruled out, you should give IBS a look into.  Irratable Bowel Syndrom.

[NickyIsHere123]

Hi, it sounds like this is your gallbladder. Your classic symptom is the yellow stool and upset tummy. I would suggest it is one of two things:  


A. Gallbladder w/ stones


B. Non functioning gallbladder


These are the tests you can request:

Ultrasound

HIDE scan ( this detects problems with functioning if no stones are found on the ultrasound)


What you can do in the meantime...treat it as though it were a gallbladder problem and go light on fatty meals. Try getting some magnesium ( powdered form) to calm the system. There is a product called ' Natural Calm"

Calm your system and stay away from fatty foods at the moment. Try juicing some beets and radishes.

[ozark]

have you been checked for cdiff with stool cultures?

[jfem]

Yikes, I hope they don't opt for that secretin test!!!  : )

Thanks again...I'm seeing another GI specialist in NYC this Thursday..Actually he's a gastro-diagnostician-whatever that means...
I just hope he can shed some light on to all of this.

Thank you for your suggestions, I don't want to waste mine or his time on Thursday, which is why I want to come as prepared as I can, with as much knowledge as I can to hopefully facitllitate either a diagnosis or even better, a cure!!!

J

[jfem]

thank you -you have given me some great thoughts.

My only question is wouldn't the pancreas be seen via the blood tests ( amalase etc..?)

How do they test the pancreas function?

[B_Johnson]

Amylase and lipase are a measure of pancreatic cell destruction.  These enzymes are normally inside cells and should not be found in the blood normally.  Thats why they are found if you have pancreatitis.

The test for pancreatic function is is a 3-day stool collection.  You are placed on a fat diet during this time. and fat content in your stool is measured over 3 days.

Another test is the secretin test.  Secretin is a hormone which is release in response to food in the small intestine.  This hormone stimulates the pancreas to release its enzymes to digest food.  This is a rather invasive test though.  It requires the placement of a small tube from your nose into your duodenum.  Secretin is sent down the tube, then the tube collects samples of the fluid in your small intestine.  Not too pleasant!!  There are some other tests that are less invasive which havent been widely adopted yet.

Dont get too worried, i doubt that the workup will require all of this.  Good Luck!

Dr. J

[B_Johnson]

It sounds like you are experiencing some sort of digestive problem.  This could be due to many things.  U/S of the gallbladder would have been a good initial investigation rather than testing for something rare like celiac sprue.  Assessment of pancreatic function should have also been preformed.  Yellow stool can represent impaired fat absorption which would be present if your pancreas was not producing adequate lipase or if the duct which empties bile and pancreatic enzymes into your small intestine were blocked.  A HIDA scan would show local blockage of the gallbladder, where as a ERCP may be necessary to evaluate for further anomalies.

Levaquin has been known to rarely induce pancreatitis, but these symptoms would have stopped shortly after discontinuing the medication.

The change in stool consitency could also reflect some sort of food allergy.  It is a good idea to keep a food diary which would eventually reveal if you are sensitive to certain foods.