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Gastroenterology (Expert Forum)
Fatigue, GERD, Other stuff
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Fatigue, GERD, Other stuff
by ckittrell, Jun 19, 2003 12:00AM
Okay, a long story.
I'm 31 year old male. Had a traveling job in mid twenties that was stressful. Got to the point that I couldn't eat a meal without feeling nauseated. Went away when I changed jobs.
Recently left comfortable job. New problems appeared. About a year ago started getting pains in my chest. History of heart trouble in family (both sides), so got worried. Dad had six stents put in at age 49. Had all the tests run. Stress, sonogram (where they looked at valves??), etc. Nothing. Said my heart was very strong. Pain came and went.
Got really sick one night about 6 months ago. Went to after hours clinic, told me that pain in my chest was GERD. Symptoms were that my chest was sensitive to the touch. Usually at our near the outside of my chest (as opposed to the middle). Got thirty day prescription for nexium, but didn't take it long. Frankly, relieved that I just had "heartburn" for all this time.
5 months ago, had a fever of 104 for about six days. Would subside with tylenol. Had spinal tap - nothing showed up. Had to get blood patch two weeks later. Still feel tingling in legs from time to time.
I'm only mildly overweight.
Heartburn returned four months ago. This time, right below my breastbond. Went to GP, who prescribed nexium again. This time I took it. Heartburn seemed to subside some (with a change in diet too).
Eight weeks ago, got bit by a tick. Prescribed Cipro and bactrium. Told don't have lymes disease. Notice my throat closing, and that I feel week and sick. Think it's the medicine. Stop taking it.
Last eight weeks have been chronically fatigued. Always had energy before (and never really went to dr. actually). Fatigue joined by chest pain (like gerd). Now, as I type, I've had such severe pain in the base of my throat that it hurts to eat.
I've thought that my fatigue could be related to the nexium. I noticed the other day that a pill I had swallowed showed up in a BM - and I could still read the writing on it! Now, I seem to pass almost everything "whole." Thought that this was the cause of fatigue - not getting calories, vitamins and minerals.
Getting an endoscopy in four days. But already told by Dr. that my fatigue doesn't have anything to do with G. I. track. Said bloodwork didn't show "anemia." Thought that it might be sinus cold or allergies.
For past few years my ears do pop when I swallow. And my nose does seem a little clogged all the time. But nothing too serious, it seems.
Finally, did have an episode a few weeks ago where I had a severe pain in the back of my left leg. Kept me up at night off and on. No swelling or anything.
Sorry for laying this all out here, I just have no where else to turn. Everyone seems to think I'm a hypochondriac. I've never been sick in my life until this year. But I'm not imagining this chest and throat pain, my severe fatigue, or other symptoms.
Any help you can offer here would be appreciated.
I'm 31 year old male. Had a traveling job in mid twenties that was stressful. Got to the point that I couldn't eat a meal without feeling nauseated. Went away when I changed jobs.
Recently left comfortable job. New problems appeared. About a year ago started getting pains in my chest. History of heart trouble in family (both sides), so got worried. Dad had six stents put in at age 49. Had all the tests run. Stress, sonogram (where they looked at valves??), etc. Nothing. Said my heart was very strong. Pain came and went.
Got really sick one night about 6 months ago. Went to after hours clinic, told me that pain in my chest was GERD. Symptoms were that my chest was sensitive to the touch. Usually at our near the outside of my chest (as opposed to the middle). Got thirty day prescription for nexium, but didn't take it long. Frankly, relieved that I just had "heartburn" for all this time.
5 months ago, had a fever of 104 for about six days. Would subside with tylenol. Had spinal tap - nothing showed up. Had to get blood patch two weeks later. Still feel tingling in legs from time to time.
I'm only mildly overweight.
Heartburn returned four months ago. This time, right below my breastbond. Went to GP, who prescribed nexium again. This time I took it. Heartburn seemed to subside some (with a change in diet too).
Eight weeks ago, got bit by a tick. Prescribed Cipro and bactrium. Told don't have lymes disease. Notice my throat closing, and that I feel week and sick. Think it's the medicine. Stop taking it.
Last eight weeks have been chronically fatigued. Always had energy before (and never really went to dr. actually). Fatigue joined by chest pain (like gerd). Now, as I type, I've had such severe pain in the base of my throat that it hurts to eat.
I've thought that my fatigue could be related to the nexium. I noticed the other day that a pill I had swallowed showed up in a BM - and I could still read the writing on it! Now, I seem to pass almost everything "whole." Thought that this was the cause of fatigue - not getting calories, vitamins and minerals.
Getting an endoscopy in four days. But already told by Dr. that my fatigue doesn't have anything to do with G. I. track. Said bloodwork didn't show "anemia." Thought that it might be sinus cold or allergies.
For past few years my ears do pop when I swallow. And my nose does seem a little clogged all the time. But nothing too serious, it seems.
Finally, did have an episode a few weeks ago where I had a severe pain in the back of my left leg. Kept me up at night off and on. No swelling or anything.
Sorry for laying this all out here, I just have no where else to turn. Everyone seems to think I'm a hypochondriac. I've never been sick in my life until this year. But I'm not imagining this chest and throat pain, my severe fatigue, or other symptoms.
Any help you can offer here would be appreciated.
Doctor's Answer
by Kevin Pho, MD, Jun 19, 2003 12:00AM
, Jun 19, 2003 12:00AM
Hello - thanks for asking your question.
You note a variety of symptoms. Without examining you, it is impossible to say what is going on.
You note fatigue and epigastric pain. Heart tests were negative. It is possible that the chest pain is dyspepsia (simply upper GI discomfort). Causes can include inflammation of the esophagus or stomach, peptic ulcer disease, or GERD. You stated that you have an endoscopy scheduled (upper or lower?). From the sounds of the story, an upper endoscopy should be performed.
If that test is negative, you may want to consider a 24-hr pH study to document whether you have acid reflux or not.
Regarding the fatigue, you may want to inquire about a Lyme test via the blood since you were bitten by the tick. I would also test your thyroid level.
As for the symptoms of passing bowel movements whole. The upper endoscopy would be a good test to evaluate for this. Other tests would include testing your stool for fat (fat malabsorption), or various breath tests for carbohydrate malabsorption. Tests for celiac disease (antibodies via the blood) can also be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
You note a variety of symptoms. Without examining you, it is impossible to say what is going on.
You note fatigue and epigastric pain. Heart tests were negative. It is possible that the chest pain is dyspepsia (simply upper GI discomfort). Causes can include inflammation of the esophagus or stomach, peptic ulcer disease, or GERD. You stated that you have an endoscopy scheduled (upper or lower?). From the sounds of the story, an upper endoscopy should be performed.
If that test is negative, you may want to consider a 24-hr pH study to document whether you have acid reflux or not.
Regarding the fatigue, you may want to inquire about a Lyme test via the blood since you were bitten by the tick. I would also test your thyroid level.
As for the symptoms of passing bowel movements whole. The upper endoscopy would be a good test to evaluate for this. Other tests would include testing your stool for fat (fat malabsorption), or various breath tests for carbohydrate malabsorption. Tests for celiac disease (antibodies via the blood) can also be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Your symptoms sound very close to mine. I too have had a very stressful job. I have numbness/tingling in my left leg/arm and head. And chest pain sensive to touch. Its like I can trigger the episode just by pressing on the left part of my left brest(kind of near the center of my chest, maybe 1 inch to the right of the center). Im not a doctor, but Id be glad to sare with you my story if you are interested. Ive posted a question here just tonight asking for advice on my condition. Im 34, male - bit overweight, diagnosed with GERD.
Regards,
Tom
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