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My symptoms but need some feedback


Jay84
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Hello and thank you for reading my story.

My symptoms began 2.5 years ago when I was 36.  Out of no where I had diarrhea often and a constant dull bulging feeling in my abdomen followed with persistant heart burn.

I booked an appt with my doctor soon after and he ran a couple blood tests and said I am fine as well as giving me some meds for the heartburn.  After a couple months of no change and stress I went back to the doctor and informed him of no change.  He sent me for more blood work and an ultra sound.  Once again, results were normal.  He perscribed me a zoloft for anxiety and booked a upper endoscopy.  He mentioned he thinks it could be IBS and not to worry. The zoloft helped the heartburn and a couple few months later I had a CT and the upper scope.  There was only inflamation noted on the scope and it was ruled as functional dispepsia.  The CT was all clear except they noted the colon was inconclusive due to fecal matter.

Since I was on zoloft, my worries went away and although my "bloating" never went away, the heartburn did.  I have been good for a couple years, until now.

Recently, I have noticed my stools changing.  Diarreah is almost every stool but I still only have 2 or 3 BM a day.  The stool is always yellowish (pale) and on the softer side.  And the stool always floats and shows more undigested foods.

I had an appt with my doctor and he said he has done all he can.  I asked him to please diagnose me or find someone who can.  He referred me back to the GI who did my scope but told me now the wait times are about 2 years to see a GI where I am from...

Any help would be very greatly appreciated.  Thank you

 


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Jeffrey Roberts

Sorry to read that you are having such a difficult time. Hard to live with diarrhea at each stool.

Your yellowish stool and pale could be as a result of fast transit through your colon or could be related to bile. Since this is new, could your family doctor check that your pancreatic enzymes are okay and that it and your gallbladder are working properly. You can do this with a blood test. You might also want to do some stool cultures to rule out anything infectious or from an ova or parasite. If your stool has a strong odour you could also ask to rule our a C Diff infection. I would do all this first before trying any medications.

I can tell you that zoloft, although helpful for anxiety, it is not the medication of choice when someone has diarrhea. It often contributes to diarrhea. A more suitable medication would be a tricyclic medication like amitriptyline, but it might not necessarily help with your anxiety. It takes someone who knows how to prescribe medications for GI patients to also address anxiety. A medication like Cymbalta might tackle both anxiety and diarrhea.

Another route to try, is to use cholestyramine which is a power you mix with water and it binds to bile reducing diarrhea. You could stay on the zoloft and try this if your doctor was willing to prescribe it to you.

If all else fails, you could use Imodium for the diarrhea. You would have to play with the amount you need so you don't become too constipated from it.

Waiting to see a GI doctor in Canada is long and painful right now. They are really backed up.

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Thank you for the response!

Yes, all my stools are extremely smelly.  They all look to be covered in a yellow coating too.

Let me know if you can think of any more testing to ask for as I have set up a doctors appt in a couple days.

 

Thanks again!

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Jeffrey Roberts

To me, that seems different than your previous symptoms. It seems like an overgrowth of Clostridium Difficile (C Diff). Do you also happen to notice if you have a fever or are having abdominal pain?

I would explain your specific new symptoms to your family doctor and they can decide whether to test for C Diff. If you can't get into your doctor, I suggest to go to a walk-in clinic.

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Hello again.

I have no severe pain right now.  I just have a constant dull small bloating sensation and my abdomen appears to be distended 24/7.  I also am slightly nausiated so I have to put in extra effort to eat or I will lose more weight.

My lower and mid back seems to have off and on cramping / squeezing sensation.  I have been really fatigued and my heart seems to race once and a while for no reason.  No fever as of yet but I did wake up soaking in sweat this morning.

Thanks again for your help!

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Jeffrey Roberts

It sounds like something acute that does need to be looked at. Those are not necessarily IBS symptoms.

I'm sorry your doctor was so dismissive. I think you'll have to try again to book an appointment.

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Okay.  I want to make sure I am very specific on the tests that I should do and I have taken note of the tests you have mentioned so far.  Please do not hesitate to reach out if you think of any additional test because I still have a couple more days before my appoimtment.

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Jeffrey Roberts

From my experience, it's not going to go so well if you ask for specific testing from your doctor. I would explain your symptoms and see what they recommend. You could ask if this could be a C Diff infection or perhaps gallbladder related. Without actually seeing you, it's impossible for me to properly assess you. It's good to be prepared before hand.

Don't worry too much about this. You'll get some reassurance from a doctor soon and hopefully feel better soon enough.

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Thanks for the advice.  I will do what you suggested.  I just hope they don't overlook things.  Literally I am trusting the doctor with my life.  

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Jeffrey Roberts

I think your symptoms speak for themselves. Try and trust your doctor. I believe they are doing their best.

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I did go for a walk-in and explained all my symptoms in great detail.  But since my file has the suspision of IBS, the doctor felt there was no need to do any tests.  I have another appointment with another doctor but I cannot garauntee they will do any tests either.

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Jeffrey Roberts

I find that rather surprising. I'm sorry you are having to convince doctor's about this. To me, your symptoms call out to being investigated.

What exactly did the doctor say?

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The doctor said to keep trying the low fodmap diet (been trying it for over a year with no success).  But he said he wasn't concerned because I am under 40 and have not lost an alarming amount of weight and I have not had persistant blood in my stool.  Then he said just keep at it and had to leave for his next patient.

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Jeffrey Roberts

Gosh. My daughter had a similar problem when a doctor had blinders on and could not seem to understand that acute GI problems occur even for those with IBS. My daughter was 19 years old at the time. She ended up going to emerg where they eventually diagnosed C Diff.

You are not likely to die from this, but your symptoms are clearly different than the usual.

You will have to try again.

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Update.  Went to the doctor today and will do some stool and blo9d tests.  It seems as though the lab and the doctor are unsure of the prep that is neeed for them (i read that i may have to ingest a certain amount of fat for 3 days for it to be accurate)  but it seems they don't know..

But now I am actually having a panic attack it is pancreatic cancer because all my symptoms match and we have almost ruled everthing else out.

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Jeffrey Roberts

I'm relieved for you that they are looking further into this.

I'm not exactly sure what your lab tests are for. I've always been thinking of something much more acute and benign like C diff or something to do with your gallbladder.

I wouldn't think about cancer. It's incredibly remote and there would have already been other markers for something like that.

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The doctor thinks it is something with my pancreas due to the stool.  He is testing pancreas enzimes, c diff, and parasites/ova.  I have be tested for other non cancerours items and have been cleared of those (eg.  Celiac, lactose intollerance...etc)

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Jeffrey Roberts

Sounds like reasonable tests.

Pancreatic enzyme testing doesn't imply cancer. Sometimes we may have less or more of them and they can affect digestion.

C Diff results take a couple of days to come back. Ova and parasites can take 7 or more days, so don't worry.

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Your comments are true but the concern is when these thing come on unwarranted, such as diabetis (and being a healthy weight).

 

I am really trying not to think the worst as you mentioned but for some reason I don't know what else it could be.  It almost seems as though there is a smaller chance of it not being cancer due to the symotoms almost perfectly matching.

 

Sorry to ramble on.  I appreciate your efforts and help.

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Jeffrey Roberts

Let's do the testing and see what returns. 🤞🏻

I'm not going anywhere so feel free to reach out if you need someone to listen while you are waiting for the results.

 

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Update:

I still need to wait another 1.5 weeks before I can do the testing as the metamucil I was taking would skew the results.

Since I have stopped all supplements and metamucil, my stools very slightly normalized.  The colour has returned to more of a normal-ish brown, however, I still have diarrhea 2 out of the 3 BM a day.  And sometimes I still notice very small amounts of what looks like oil.

Since I have been monitoring this lately, I do have a very strong feeling that whatever I eat comes out within 8 hours (usually 6).

I believe I have my stress in order but for some weird reason, I have almost like a "panic" sensation feeling even though my thoughts were not thinking anything to warrant it. Not sure if that makes sense to anyone..

Anyways, that's all I got for now.

Cheers

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Jeffrey Roberts

I didn't realize you were using metamucil to manage your IBS-D. While useful for some people with diarrhea, it can also produce more diarrhea and bloating depending on how much and how long you have been using it.

If your stools are more normal-ish brown then I'm encouraged it is likely not C Diff. Oily implies a host of things, but usually gallbladder or pancreas related. I'm starting to feel that your situation might be diet related. Good that your doctor is looking into it.

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Your symptoms sound like EPI to me. I don't have it but I've read about it and seen commercials for treatment for it. I have IBS-D and find that if I take a 12.5 mg dose of Xanax in the morning, my stress level decreases some. I've also switched from Imodium to kaopectate. Imodium would take care of my diarrhea, but cause me to be blocked up for three days afterwards, then the cycle would start again. Kaopectate doesn't do that. For your nausea, try smelling some lemon essential oil, it really helps me. I keep an inhaler of it in my purse and pull it out and take a few whiffs whenever I'm nauseated, which is frequently, it won't hurt me, and it doesn't have any side effects.

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Thank you very much for the response!!

Here is another little update:

I am still in progress on completing the many stool samples as it will take about a week to complete.

I did the bloodwork though.  He did a total blood check on everything under the sun it seemed.  The only things that came back slightly elevated were triglycerides amd ALT.  I had a review with my doctor on the results and he told me it was nothing to worry about.

After going through this, I realized it has struck fear and panic in me almost on a daily basis.  I thought I didn't need my anxiety meds anymore but I told my doctor all the panicing, dread, trembling, and stress I was having.  We agreed that i should start taking my anxiety meds again..

I asked him truethfully because I am still scared about cancer (which I have had a history on of many physical symptoms I get), if he thought there was anything sinister going on like a cancer - He told me he does not think it is, even given all this extreme symptoms I have..

I started taking citroplam yesterday.

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