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COUPLE with STOMACH PROBLEMS/RECOMMENDATION REQUESTED
I am hoping for some direction in addressing a long-standing stomach problem that affects both my husband and I. Our HMO that has conducted some tests but they have not been able to identify a cause of the stomach problems.
For myself, the problems seemed to start about 6 years ago living in Philadelphia when I was 34. I experienced about a week or so of intense stomach pain, cramping and diarrhea. When I went to the doctor afterwards, I was asked if I had been out of the country and in fact my husband and I had been to Japan not long before. I was not given any tests however and my symptoms were dismissed as "stress." I became lactose intolerant either shortly before or concurrently with this stomach event. Fatty or fried foods also began causing me to have next-day diarrhea not infrequently. Over time, my lactose intolerance has become more pronounced and I have lost my prior ability to digest many foods without experiencing some degree of stomach pain and or next-day diarrhea.
About the same time, my husband started having stomach problems as well. He was also 34 years old. He began having urgent diarrhea (about 1 hr after eating), mostly caused after meals out at first but eventually the problems happened after meals at home as well. He began having symptoms of lactose-intolerence even though his family has no history of lactose intolerance. He also began having trouble with fatty foods causing urgent diarrhea or hours of gas. His symptoms became more severe over time and interfered with daily life to where he could not eat out or with other people. My husband must restrict his meals at work so that stomach problems do not occur during business hours. About 2 years ago, the HMO gave him a battery of standard tests including a colonoscopy, upper G.I., complete blood count without differential and liver function panel, basic metabolic panel, T.S.H, inflammatory bowel syndrome (ASCA IGA, ASCA IGG, OMPC IGA, CBIR1 AB, NSNA PERINUCLEAR, DNASE IFA), Celiac disease antibody panel, INR - Prothrombin Time on Whole Blood, Giardia lamblia and Cryptosporidium parasite screen, fat stool screen, stool white blood cell, and stool culture. The test results were normal with the following exceptions: his Gliadin IGG, EIA was high(62), his Blood Urea Nitrogen was low (7), and his MCH was high (31.8). Another important note--the doctor who conducted the colonoscopy said emphatically that his stomach problem is definitely NOT I.B.S.
At my insistence, the HMO gave me a test for Giardia 2 years ago (they took 1 stool sample and it came back negative.) Over time, we have discovered that having wine with a meal virtually eliminates our symptoms of gas, and/or stomach pain and/or diarrhea (as long as we avoid fatty foods and dairy products as well.) Hard liquor does not seem to help the way wine does. If we do not have wine with the meal, we will frequently experience stomach pain and/or extraordinary gas and/or next day diarrhea (me) or urgent diarrhea (my husband). Nonetheless about once every week to two weeks, my husband is experiencing urgent diarrhea about 1 hr. after eating, regardless of the type of food that is eaten.
Our HMO doctors have been dismissive about the problems we continue to have even though we have explained that we are experiencing what seem to be similar symptoms, despite having very different genetic backgrounds. We are frustrated by these continuing stomach issues that have affected our quality of life and are willing to go outside our HMO to find answers but do not know who can help us. We would like to find a doctor who has a good track record with stomach disorders.
We are hoping to get a recommendation to a well-regarded specialist in the Atlanta area. Can you give us a name or help us locate a doctor in Atlanta who is known for solving stomach problems? Your suggestions are appreciated!
For myself, the problems seemed to start about 6 years ago living in Philadelphia when I was 34. I experienced about a week or so of intense stomach pain, cramping and diarrhea. When I went to the doctor afterwards, I was asked if I had been out of the country and in fact my husband and I had been to Japan not long before. I was not given any tests however and my symptoms were dismissed as "stress." I became lactose intolerant either shortly before or concurrently with this stomach event. Fatty or fried foods also began causing me to have next-day diarrhea not infrequently. Over time, my lactose intolerance has become more pronounced and I have lost my prior ability to digest many foods without experiencing some degree of stomach pain and or next-day diarrhea.
About the same time, my husband started having stomach problems as well. He was also 34 years old. He began having urgent diarrhea (about 1 hr after eating), mostly caused after meals out at first but eventually the problems happened after meals at home as well. He began having symptoms of lactose-intolerence even though his family has no history of lactose intolerance. He also began having trouble with fatty foods causing urgent diarrhea or hours of gas. His symptoms became more severe over time and interfered with daily life to where he could not eat out or with other people. My husband must restrict his meals at work so that stomach problems do not occur during business hours. About 2 years ago, the HMO gave him a battery of standard tests including a colonoscopy, upper G.I., complete blood count without differential and liver function panel, basic metabolic panel, T.S.H, inflammatory bowel syndrome (ASCA IGA, ASCA IGG, OMPC IGA, CBIR1 AB, NSNA PERINUCLEAR, DNASE IFA), Celiac disease antibody panel, INR - Prothrombin Time on Whole Blood, Giardia lamblia and Cryptosporidium parasite screen, fat stool screen, stool white blood cell, and stool culture. The test results were normal with the following exceptions: his Gliadin IGG, EIA was high(62), his Blood Urea Nitrogen was low (7), and his MCH was high (31.8). Another important note--the doctor who conducted the colonoscopy said emphatically that his stomach problem is definitely NOT I.B.S.
At my insistence, the HMO gave me a test for Giardia 2 years ago (they took 1 stool sample and it came back negative.) Over time, we have discovered that having wine with a meal virtually eliminates our symptoms of gas, and/or stomach pain and/or diarrhea (as long as we avoid fatty foods and dairy products as well.) Hard liquor does not seem to help the way wine does. If we do not have wine with the meal, we will frequently experience stomach pain and/or extraordinary gas and/or next day diarrhea (me) or urgent diarrhea (my husband). Nonetheless about once every week to two weeks, my husband is experiencing urgent diarrhea about 1 hr. after eating, regardless of the type of food that is eaten.
Our HMO doctors have been dismissive about the problems we continue to have even though we have explained that we are experiencing what seem to be similar symptoms, despite having very different genetic backgrounds. We are frustrated by these continuing stomach issues that have affected our quality of life and are willing to go outside our HMO to find answers but do not know who can help us. We would like to find a doctor who has a good track record with stomach disorders.
We are hoping to get a recommendation to a well-regarded specialist in the Atlanta area. Can you give us a name or help us locate a doctor in Atlanta who is known for solving stomach problems? Your suggestions are appreciated!
In your husband's case, I'd suggest he followup with a fecal antibody test for celiac issues and also check his cross-reactivity to casein (a major protein in milk) considering his results on the gliadin/EIA test. You can order that test kit through Enterolab. Check online. With the results of his tests through the HMO, his doc should have started him on a gluten-free diet almost immediately, and it wouldn't be a bad idea to start that now. It woulld mean excluding wheat, rye, barley (and sometimes oats) from his diet. And if he's cross-reactive to casein, dairy of all forms would also have to be removed. 'Silent' celiac can show up in adults, and it is in fact on the rise. Unfortuantely most docs haven't caught up with that fact yet.
Other symptoms can include severe fatigue that can be long-lasting or hit like a ton of bricks. There can be 'brain-fog' and unexplained rashes or blotches as well as peripheral neuropathy after a period of time.
He's 'lucky' to have had those small indications in his blood test, as the blood test is not that good (IMO). The fecal antibody test is much more sensitive.
So if he feels like having confirmation, try the fecal antibody test. But he may want to start a gluten-free diet today. It will probably start to take weeks to feel better, but the faster he starts the sooner that is going to happen.
Other symptoms can include severe fatigue that can be long-lasting or hit like a ton of bricks. There can be 'brain-fog' and unexplained rashes or blotches as well as peripheral neuropathy after a period of time.
He's 'lucky' to have had those small indications in his blood test, as the blood test is not that good (IMO). The fecal antibody test is much more sensitive.
So if he feels like having confirmation, try the fecal antibody test. But he may want to start a gluten-free diet today. It will probably start to take weeks to feel better, but the faster he starts the sooner that is going to happen.
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