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Gastroenterology (Expert Forum)
5 years
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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5 years
by geno1, Nov 30, 2005 12:00AM
I am a 28 year old caucasian male, used to always be healthy and normal. Starting about 5 years ago I suddenly had abdominal pains and digestive problems. Lots of gas, strange stools, and mild pains. Mostly constipated and slowed down, but occasionaly diarrea. Right away I found milk aggravated the problem, so I have been basically dairy free. Blood in stool a few times a year. Also about once a year I get an extremely painful attack/episode at about 5AM. It feels like something wrong deep inside. They last about 10-20 mins. Then eventually I will have a bowel movement and start feeling better.
About 2 years ago, I started having new problems in addition to those above. Heart pounding really slow and hard at times, random muscle twitches, head pains in different places on my head that last a few seconds, ear aches that last a few seconds, and bad headaches that can last for hours. Also 'mental fog' or lethargy or lack of focus, everyday. This is my biggest complaint. I am a programmer and im not able to work now. Seems to be affected by what I just ate, but I can never pin it down to one food. AND, strangest of all, I seem to get gas/pressure in my sinuses. Literally gas seems to build up in my sinus cavitys, and bubble out at my eyes, or come out into my nostrils. None of my doctors have ever heard of it. And everything seems to act up at night after ive lain down for bed.
I have had many blood tests, colonoscopy w/ biopsy, abdominal CT, stomach endoscopy w/ biopsy, sinus xray, M2A pill cam, abdominal ultrasound, stool fat & parasite tests, hida scan w/ cck, & skin ***** food allergy test for 20 foods. All unremarkable.
I have tried prevacid, imipramine, levsin, and prednisone. The prednisone did help with the mental and i felt better during the day, but always the same symptoms at night. My small bowel biopsy showed no sign of celiac, but Im trying gluten free diet anyway. 6 weeks so far, no help or change. Doctors have talked about Irritable Bowel, Inflammatory Bowel, and Marfans... but no solid diagnosis for me.
1. Recently my iron serum level tested for the first time. It was high at 176 ug/dl, fasting 14hrs. My doctor thought nothing about it, but I heard about a disease Hemochromatosis. Shouldnt I be tested for this?
2. Im worried about the sinus pressure/gas. Have you EVER heard of this? What kind of doctor should I see?
3. Any ideas in general?
thanks! sorry long post!
About 2 years ago, I started having new problems in addition to those above. Heart pounding really slow and hard at times, random muscle twitches, head pains in different places on my head that last a few seconds, ear aches that last a few seconds, and bad headaches that can last for hours. Also 'mental fog' or lethargy or lack of focus, everyday. This is my biggest complaint. I am a programmer and im not able to work now. Seems to be affected by what I just ate, but I can never pin it down to one food. AND, strangest of all, I seem to get gas/pressure in my sinuses. Literally gas seems to build up in my sinus cavitys, and bubble out at my eyes, or come out into my nostrils. None of my doctors have ever heard of it. And everything seems to act up at night after ive lain down for bed.
I have had many blood tests, colonoscopy w/ biopsy, abdominal CT, stomach endoscopy w/ biopsy, sinus xray, M2A pill cam, abdominal ultrasound, stool fat & parasite tests, hida scan w/ cck, & skin ***** food allergy test for 20 foods. All unremarkable.
I have tried prevacid, imipramine, levsin, and prednisone. The prednisone did help with the mental and i felt better during the day, but always the same symptoms at night. My small bowel biopsy showed no sign of celiac, but Im trying gluten free diet anyway. 6 weeks so far, no help or change. Doctors have talked about Irritable Bowel, Inflammatory Bowel, and Marfans... but no solid diagnosis for me.
1. Recently my iron serum level tested for the first time. It was high at 176 ug/dl, fasting 14hrs. My doctor thought nothing about it, but I heard about a disease Hemochromatosis. Shouldnt I be tested for this?
2. Im worried about the sinus pressure/gas. Have you EVER heard of this? What kind of doctor should I see?
3. Any ideas in general?
thanks! sorry long post!
Doctor's Answer
by Kevin Pho, MD, Dec 01, 2005 12:00AM
, Dec 01, 2005 12:00AM
To answer your questions:
1) Hemochromatosis can be tested by measuring the ferritin level. This can be considered if the symptoms are continuing - although they are not characteristic of this disease.
2) A sinus CT can be done to evaluate the sinuses. An ENT would be the appropriate specialist to evaluate these symptoms.
3) You have had a pretty comprehensive GI evaluation. You can consider more specialized testing including a gastric emptying scan or esophageal motility studies.
These options can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_b
1) Hemochromatosis can be tested by measuring the ferritin level. This can be considered if the symptoms are continuing - although they are not characteristic of this disease.
2) A sinus CT can be done to evaluate the sinuses. An ENT would be the appropriate specialist to evaluate these symptoms.
3) You have had a pretty comprehensive GI evaluation. You can consider more specialized testing including a gastric emptying scan or esophageal motility studies.
These options can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_b
Deficiencies in the strength or the efficiency of the LES lead to various medical problems involving acid damage on the esophagus.
It would not cure your problem,but bring some relief.
When do you eat in the evening?
try not to eat 3 hours before bedtime,if possible,eat something alkaline ,not acidic,like soda cracker.
Try eating red delicious apple and see if it makes any difference.
Keep a daily log of what you eat and when you eat
Dinner is usually my largest meal. The only other way it differs is I will have more meat and more veggies then other meals. I have tried being careful not to eat late at night. Note that I can and do get bowel pains and 'events' at any time of day.. but something about bedtime, it acts up the most.
And I do get reflux sometimes. Even all the way up to my mouth. But no heartburn. Maybe I will try doing my eating early in the day and nothing in the evening at all.
Im worried about the sinus gas thing. It must be coming up from my stomach, but why doesnt it take the path of least resistance and burp out?!
Oh I forgot to mention another one of my weird symptoms above. After I urinate I still have a significant amout of urine that can leak out, for example if I go and sit down. So I have to be through when I go.
I had that problem just yesterday and the allergy pill works for me.