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tazechip
tazechip, Board Certified Physician
Category: Endocrinology
Satisfied Customers: 32674
Experience:  Board certified in general practice with years of experience treating diabetics with multiple other medical conditions
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Hello,Just over a year ago I was ‘diagnosed' with IBS but

Customer Question

Hello,
Just over a year ago I was ‘diagnosed’ with IBS but since then I have been mostly fine, eating ‘danger’ foods in moderation and generally pursuing a healthy lifestyle. However, for the last six weeks I have experienced a debilitating flare-up that started with dark green excrement at the end of July. Having immediately changed to a totally dairy- and gluten-free diet my excrement improved (normal colour with just occasional diarrhoea) but I struggled with other symptoms, primarily nausea and loss of appetite, but also fatigue, dizziness, weight loss, sleep deprivation and abdominal muscle spasms (rarely severe cramp).
It takes me about 7-10 days to recover, but then I suffer a setback and revert to my prior condition - it’s almost a week-on, week-off cycle. I didn’t feel stressed when it initially started, but anxiety is proving a trigger of late - the latest example was a date last Sunday that didn’t go too well. I was unable to eat my evening meal, slept poorly and then felt nausea the following day that reverted me back to my prior condition.
The nausea makes it very difficult to function; I haven’t embarked on an evening social occasion for over a month, I’ve taken a number days off work (which, as a contractor, I don’t get paid), I find it difficult to concentrate on simple things like reading, and force-feeding has become an ordeal. Mornings are the worse; I tend to just sit in the bath for an hour. I feel down and frustrated, but not depressed as I think I have things to look forward to. I’m due to date a girl I like but I keep putting it off until I feel better and now I’m worried about it triggering symptoms like last time.
I’ve spoken to doctors numerous times and they’ve put me on anti-nausea tablets, beta-blockers, buscopan, and probiotics but the effects seem minimal at best. I’ve also tried ginger capsules, peppermint tea, etc for nausea. I’m also due to speak to a psychologist, and I’ve been referred to the hospital but that isn’t until November. I’ve tried a food diary but can’t find any definite patterns so now I’m wondering if there’s something I’m eating regularly (like bananas, rice, fish, etc) which is causing a problem. It’s all quite confusing and overwhelming; it’s almost like I need someone to say: “This is what is wrong and this is what you need to do,” but my GPs have pretty much given up.
Any advice would be greatly received as I feel as though my life is on hold and I’m unable to take advantage of the opportunities life can offer a 32-year-old Londoner.
Submitted: 3 years ago.
Category: Endocrinology
Expert:  tazechip replied 3 years ago.
Hi Sorry for the delay in getting to you but I just got your question. First off how was the IBS diagnosed and have you recently had any studies or procedures done to evaluate this?
Customer: replied 3 years ago.

It first emerged just over a year ago when I started getting daily diarrhoea. I can't say it was officially diagnosed; rather the doctors said IBS was their best guess as there was no blood in my stool or any obvious abdominal swelling.

I was tested for coeliac, anaemia and thyroid issues, and was recently given a stool test - all clear. They detected slight inflammation in one other blood test, but nothing significant.

Expert:  tazechip replied 3 years ago.
OK Adam. So you haven't had upper and lower endoscopy? Have you been screened for H pylori infection?
Customer: replied 3 years ago.

No. I haven't been given an endoscopy although I have been referred to the hospital - unfortunately not until late November. I'm not sure about H pylori - is this done via blood test?

Expert:  tazechip replied 3 years ago.
No--it's done either by specific stool testing or with a breath test. We can continue after this if you'd like Adam, but here are my thoughts. You need the endoscopies and the H pylori screening. IBS is a diagnosis of exclusion--made when other possibilities are ruled out. I very much doubt celiac from what you've said, but it really takes biopsies from upper endoscopy to rule that out. I would also check your thyroid function if that hasn't been done up to now since some of your symptoms sound like a low thyroid problem. My first thought, though, is H pylori and if that screening is positive, it can be eradicated with a course of two antibiotics
Customer: replied 3 years ago.

Apologies for the delay.

I saw a private doctor yesterday who took a blood sample to test for allergies and H pylori, as I wasn't sure if I'd had that test with my NHS GP. I'm pretty sure I've been tested for thyroid issues though. As a side, he confirmed that there are no lumps/swelling and prescribed me mebeverine and cyclizine as the nausea is particularly debilitating.

It sounds like there isn't much else I can do but wait for the endoscopy, but my hospital appointment isn't for another eight weeks so it could prove a frustrating wait. A few final questions I have: Is the one week feeling fine, one week feeling terrible unusual? Is it rare to take a week to recover to a trigger? And how should I approach the possibility that it's psychological? (I keep asking myself - "Is this all in my head?")

Expert:  tazechip replied 3 years ago.
IBS and H pylori can both come an go and with IBS stress and anxiety can trigger it but that doesn't mean it's in your head Adam. Please keep in touch and let me know how it goes
tazechip and other Endocrinology Specialists are ready to help you
Customer: replied 3 years ago.

Thanks for your time. I suppose it's just tough not having a diagnosis and thinking I might have to struggle for another 2-3 months until my hospital appointment.

Expert:  tazechip replied 3 years ago.
Wish I could do more for you Adam but please keep in touch
Customer: replied 3 years ago.

Just to confirm, has my deposit gone through or do I need to do something else for this payment to be made? Thanks.

Expert:  tazechip replied 3 years ago.
It went through Adam and thanks
Customer: replied 3 years ago.

Quick update in case anyone else with my issue reads this:

Saw a doctor privately on Friday and am now waiting results for blood tests, one of which is H Pylori.

In the last couple of days I've developed a slight burning sensation on my left side, which I think occurs prior to eating.

My day-to-day remains a struggle - I can get about but I'm still struggling with my appetite, nausea, and fatigue.

Expert:  tazechip replied 3 years ago.
Let me know what the test results show Adam
Customer: replied 3 years ago.

Hi. The blood test came up negative for H Pylori and my doctor is now stool-testing for parasites but I'm not holding out much hope. I'm not quite sure where to go from here as all the test results are coming up negative yet I'm still struggling with my appetite; my stomach is permanently tight and rumbles throughout the day. I'm frustrated rather than stressed/depressed as it's affecting both my social and professional life.

Expert:  tazechip replied 3 years ago.
We need to see what the stool results show Adam
Customer: replied 3 years ago.

Another quick update.

The stool tests came back clear.

I have since seen a specialist privately who was concerned about my weight loss and recommended I receive scans and endoscopies as soon as possible, but this process is lengthy on the NHS and it doesn't look like that will happen until November.

I'm still struggling with my symptoms and have been confined to my bed for the last few days. Eating remains difficult due to a loss of appetite and coping with the mental side is becoming increasingly difficult. It's been a two-month nightmare that looks set to continue.

Expert:  tazechip replied 3 years ago.
What did the specialist have to say Adam?
Customer: replied 3 years ago.

He didn't think it was just IBS because I've lost around 10kg and so wants to give me scans and endoscopies to hopefully reach a diagnosis. He suggested Crohn's Disease as a possibility.

It just means more waiting though (I have to wait two weeks before a date is even set) and I'm also scared that nothing will show on the tests and I'll be forever stuck with this debilitating nausea.

Expert:  tazechip replied 3 years ago.
Has anyone considered giving you a course of prednisone?
Customer: replied 3 years ago.

No. This medication hasn't been mentioned yet.

I've been prescribed a range of medications from Colofac to Propanolol to Landsoprazole, but to little effect, and when I showed the specialist he said to just quit taking meds.

Is prednisone I should ask my GP about?

Expert:  tazechip replied 3 years ago.
Yes since that could well help with your appetite problem and on the chance that this is Crohn's it would be a first-line medication for that. I can't say it is Crohn's but that's what I would try for now.
Customer: replied 3 years ago.

Thanks for the tip. If I can just somehow relieve the constant nausea then that would make a huge difference.

Expert:  tazechip replied 3 years ago.
Let me know how it goes Adam