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4 different doctors, 4 different diagnoses! What to do now?

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Irritable Bowel Syndrome
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Posted 6/28/2014 3:53 AM (GMT 0)
I've been having increasing trouble with my digestive system for the last 2 mos. In the last 3 weeks, I've gone to 4 different doctors and have gotten a different diagnosis every time I go. Who do I believe?? This is so frustrating!

Here are my symptoms:
1. nausea- this was the first symptom to appear and is the most constant. I have it a lot of the time when I wake up and a few hours after I eat one of my trigger foods. Tums and Pepto haven't really helped.
2. stomach pain- I have 3 different kinds. The 1st is a dull ache that I'll get along with the nausea in my entire stomach area, the 2nd is a sharp pain that lasts for about 30secs in my right upper abdomen and then comes and goes many times. This one also can happen other places on my stomach but is most frequently in the upper right quadrant. And the 3rd type is like cramps and gets better after a bm.
3. bloating-
4. tenderness to touch- mostly the upper part right under my rib cage.
5. headache- really strong headaches have been coming on right after I eat a trigger food.
6. fatigue-
7. constipation- I've been able to go but have had to strain a lot more than normal
8. diarrhea- happens occasionally after eating a trigger food and is tied to pain #3

Triggers:
coffee, especially lattes :(
anything with a high fat content- burgers, milkshakes, chicken fingers, queso, etc

Here's what my doctors said.

Dr #1 (family dr)- I gave him all of my symptoms and then he pushed on my stomach right above my ribcage and it was really painful. He said, "I'm suspicious of your gallbladder". Prescribed me Zofran for the nausea.
Dr #2 (Allergist)- Gave me a test for a milk and coffee allergy, both were negative. Said that he thought it was acid reflux or my gallbladder
Dr #3 (Urgent Care dr)- I was in so much pain one night that I had to go to an urgent care center. The Dr decided that it was anxiety and prescribed me Valium (made me feel like a zombie) and pepto bismol.
Dr #4 (different gp)- Was horrified that Dr 3 gave me Valium and told me to stop taking it. Gave me a h pylori test, ordered blood work, and scheduled me for an abdominal ultrasound next week. However, she told me that I have IBS without waiting for the tests to come back and prescribed me Prilosec and Colace.

Can anyone recognize their symptoms or have a suggestion on what to do next? I'm really tired of eating brown rice and turkey.

Thanks to all.
Posted 6/28/2014 9:57 AM (GMT 0)
I suggest seeing a gastroenterologist (GI) and having an endoscopy. Many of your symptoms could be due to mild dehydration and food intolerances but it is always best to have a professional view the insides of your digestive system when there is a dramatic increase in pain.

Your fourth doctor followed the steps that are currently used to rule out causes other than IBS. The other doctors were off the mark. The ultrasound will hopefully rule out gallbladder problems. I would feel comfortable continuing to work with her and a Gi that she likes.

High fat foods are very difficult to digest. Lactose and wheat intolerances give me symptoms very similar to yours. Your pain obviously travels with your food. Intolerances are not identified by allergy tests so you will have to keep a good food journal and do a bit of self-testing. The good news is you may not have to cut out lattes--just switch to vanilla soy lattes!

Many IBS patients experience great success with a FODMAP diet. FODMAP stands for fermentable oligo-, di-, and monosaccharides and polyols.)
Basically, it is a diet that eliminates highly fermentable carbs. The lowest success rate I have seen in studies was 75%.

I found Kate Scarlata's FODMAP website very useful. You will find very good directions there on how to find not just your trigger foods but which combination of foods create problems. My family actually liked many of the recipes in her 21-day Fodmap plan. We also tried the original fodmap plan but the recipes were horrible.

I hope your pain gets better very soon. This stupid condition can be so painful! Living on a FODMAP diet is not hard and can be delicious.
Posted 6/28/2014 2:29 PM (GMT 0)
Thank you for the suggestions.

Dehydration is most definitely not the cause- I'm drinking about 12 glasses of water a day.

I went to the Allergist to deal with a new case of peanut allergies (In the last 6 mos I've deveoped 3 new serious allergies (treenuts, bactrim, peanuts)). I showed him the food dairy that I've been keeping for a few weeks while I was there and asked if he thought I had an allergy/intolerance to dairy or coffee. He said no because a lot of my triggers were not related to these, but added those to the stick test that they were doing anyway.

I also asked my gyno at my annual exam if he thought it could be a reproductive system problem. He cleared me of that.

I have a family history of IBS (sister who also has gluten and dairy intolerance), acid reflux (grandma), gallbladder problems (cousins, who had to get their's out while they were teenagers), and had previous problems with depression (was able to work through it with counseling). I'm a 21 yr old female at a healthy weight, which I think is what made the last Dr lean towards IBS.

I will try out the FODMAP diet. I work at a job where we have to go to business lunches, which is where a lot of my food triggers have come from. Are there any safe restaurant foods that you suggest?
Posted 6/28/2014 2:45 PM (GMT 0)
You didn't actually get four different diagnoses. You had four doctors offering you a guess, and most of the doctors included both gallbladder and reflux.

The fact that you have pain associated with fatty foods points to a gallbladder issue. Gallbladder problems are usually diagnosed via abdominal ultrasound and a HIDA scan. Or you can avoid fatty foods and see how you feel.

Coffee is very difficult for people who have acid reflux. You might have reflux occasionally (meaning, not always), especially as you cycle through your month's hormonal changes. Progesterone is high in the 2nd half of a menstrual cycle, making the digestive process slow down - this can lead to stool back-up and encourage reflux. Tenderness around your sternum is also a good indicator of reflux.

Walking up nauseated sounds a lot like reflux too. You can get an over-the-counter Proton Pump Inhibitor like Prevacid and take it as directed for two weeks. See if that helps. And avoid coffee and other high acid foods.

Lactose intolerance is very, very common. In fact, almost all adults are lactose intolerant to some degree. This can also change day-to-day, and many people become quite lactose intolerant following a stomach virus. Your complaints seem to be more chronic than that - if you want to explore this, drink a glass of milk on an empty stomach and see how much belly gas you produce over the next 30 minutes. Nausea, belching and/or cramps (maybe even diarrhea) will give you an answer. If you are lactose intolerant, the solution is simple - avoid lactose (soft cheese, ice cream - you can get lactose free milk - and/or get lactase enzyme pills and take a couple before a dairy meal).
Posted 6/28/2014 3:21 PM (GMT 0)
Kazbern, thank you for the suggestions. Do you know if the reactions to coffee and lactose can come on suddenly? I was drinking about a gallon of skim milk a week and having 2-3 cups of black coffee every morning before I started getting sick. I switched all of my normal drinks to water (mik, coffee, orange juice) a few weeks ago. The only time I will drink coffee now is a latte before a Drs appointment so they can see my symptoms.

about 3 mos before I started getting the digestive issues, I had a severe asthma exacerbation where I was given 10 days of prednisone and an antibiotic to clear away a lung infection. Well, the antibiotic didn't work and the lungs kept getting worse (I've had multiple cases of pneumonia w the asthma), so my doctor prescribed me Bactrim. 2 days later I was in the ER with a severe allergic reaction to the Bactrim. They shot me up with an IV of steroids and antihistimine and sent me home with another 10 days of prednisone and week of anitbiotics. Do you think that all of this trouble could have weakened my immune system or something and brought on my issues now? I didn't have a normal cycle for 2 mos after.
Posted 6/28/2014 8:57 PM (GMT 0)
Steroids are notorious for causing acid reflux.
Posted 6/29/2014 12:57 AM (GMT 0)
Yeah, I had a bunch of really horrible side effects with the steroids, but thankfully I've been off them for almost 3 mos. The DR said that the Prilosec helps both acid reflux and IBS, so hopefully that will start kicking in.

This has all been kind of scary for me, so thank you all for answering my questions and listening to my worries :)
Posted 6/29/2014 5:50 AM (GMT 0)
Once I figured out what was "safe" for me eat I had no problems with business lunches. Before that, however, lunch could be very treacherous with limited healthy choices. What country and region do you live in? I eat at a lot of Thai, Japanese, Vietnamese, kosher Jewish and French restaurants because of where I live. There are always healthy choices for me on the menu at these ethnic restaurants. I avoid American and Italian restaurants because too often I have been presented with meals that were supposedly safe but when presented obviously contained problem ingredients.i have also had very good experiences at American fusion food restaurants.
Posted 6/29/2014 1:51 PM (GMT 0)
Jennyhart, I want to add that if Prilosec doesn't give you relief, switch to another PPI. sometimes one will work better than another for a person.
Posted 7/1/2014 8:09 PM (GMT 0)
Jenny - I have IBS, GERD and LPR and "mild" wheat allergy. Coffee is a major trigger for my IBS. I can be guaranteed to be in the bathroom within 15 minutes of drinking regular coffee. I replaced it with Puroast low acid coffee. It's not delicious, but it gets the job done and has helped reduced the violent trigger that regular coffee has on me.

I cut wheat out for 8 months or so and saw many symptoms reduced. When I eat wheat, I feel no immediate effects but it does sometimes make me constipated, which is very uncomfortable for me since my colon usually has nothing in it. If you know something bothers you, try quitting it for a while. Maybe lactose free milk? Or almond milk?

My biggest suggestion - see the GI and if you can't do that right away, spend some time trying an elimination diet. I have had to cut out a lot of foods I used to eat on a regular basis - no tomato based sauce foods, cut way down on beans, cut down on seasonings on food, cut way down on eating out, no greasy foods. And as far as eating with coworkers, that's a toughie. Everyone I work with knows about my issues and try their best to accommodate me, but if I know I cannot find something, I would really rather that everyone else enjoy their food from there and either ask for an altered menu item (grilled chicken breast and a side of plain rice, for example) or just bring my own. I'm sure everyone has their silent judgments of me, but I don't care - I don't want to be sick and their opinion is not worth the stress.
Posted 7/3/2014 6:31 PM (GMT 0)
It sounds like a gall bladder problem to me... good luck, and I would ask for an ultrasound.
Posted 7/7/2014 5:13 PM (GMT 0)
I have the ultrasound on Thursday. None of the other tests came back positive, so I'm almost hoping that this does show something so I can have answers.

I've been taking the Prilosec and Colace for about 10 days and am still having symptoms. I would say that the morning nausea is slightly better but I'm still having almost daily flare-ups while I eat something (even sometimes when I'm eating something bland and that I think is safe). I tried drinking a glass of skim milk like you all suggested and didn't have any noticeable issues. I'm hesitant to say that it's wheat related because a lot of my symptoms aren't brought about wheat products and I eat a fairly low-gluten diet naturally.

Does anyone have bad headaches and fatigue along with digestive issues? It seems like the more my digestive symptoms flare up, the more exhausted I am.
Posted 7/7/2014 5:36 PM (GMT 0)
You know, migraines are often accompanied by digestive problems (nausea, diarrhea). Is it possible that you've got some of the issues reversed - that migraine is causing the nausea and diarrhea, instead of the digestive problems giving you headaches?

Reflux can take a long time to resolve. My daughter has been taking a ppi on and off for 4 years now. Sometimes things are better, sometimes they're worse. Hang in there. You might find it helpful to read and post over on the GERD forum.
Posted 7/7/2014 5:56 PM (GMT 0)
The majority of my symptoms are independent of the headaches. If they are not, the nausea and stomach pain normally precede the headaches.

I don't have any of the characteristic problems of GERD, like heartburn, coughing, or trouble swallowing. The Dr I saw said that the PPI would relieve some of my discomfort with ibs. I've also tried popping tums at my stomach pain and it doesn't have any real impact.

Thank you all so much for your guesses and tips- you've all been a lot more persistent than any of the drs I've gone to.
Posted 7/7/2014 6:24 PM (GMT 0)
It bugs me that your DR would say this about GERD. Your post above notes that all of this cascade of events started with a terrible asthma flare that led to a lung infection. Maybe it was aspiration?

You should probably have an endoscopy to see what's going on in your stomach. Your issues are persistant and hard to diagnose without further testing, honestly.

Remember that people feel things in all kinds of ways, and sometimes it's hard to find the right words to describe what's going on. My daugher's GI said, for example, that some people have horrible pain and little pathology when scoped; some people have horrible pathology and little pain.
Posted 7/14/2014 11:17 PM (GMT 0)
I just got the results back from the abdominal ultrasound- completely clean. I started taking a B12 supplement for the headaches and fatigue and it actually helps a lot. I also added a stronger probiotic and aloe supplement to help calm down my stomach.

I went back to the doctor and she said that with all of the negative tests, my symptoms, and family history, that in all likelihood I have IBS with a side of gastritis (probably irritated by all of the prednisone I took this spring). She prescribed me a different medicine for the constipation and asked me to come back in 3 weeks, when she'll see if I can go off of the Prilosec (I agreed with her about not wanting to be on it long term if it could be avoided).

She said that she would refer me to a GI, but I think I'm going to wait and see if I can manage with diet changes, exercise, natural supplements, and some minimal medication. There's a really good natural foods/health store where I live that I'm planning on getting very familiar with.
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