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I Am Not Sure What To Do Next. In April,

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Posted on Sun, 8 Sep 2019
Question: I am not sure what to do next. In April, I got a pinching sensation in my mid spine followed by occasional twitching at my sternum. The same evening, I had really bad diarrhea and I felt inflamed for a week before feeling improvement. 3 weeks later, In May, I started to get diarrhea and a burning stomach with bloating and burping. Also, I lost my appetite. I do not have nausea or vomiting and I enjoy food until it bothers my stomach or intestines. The diarrhea comes and goes. The burning has pretty much stopped for now and I have been taking an acid blocker, but I still get bloating and burping. Burping is worse with water and things like "Boost" meal replacement. Sometimes I notice more bloating than other times, but I am burping and bloating every day. I have pretty much been a nervous wreck since the end of May. I got an endoscopy and colonoscopy. They didn't find anything during the colonoscopy, but they found redness in my stomach and lower third of my esophagus during the endoscopy. I had a HIDA scan. Gall bladder is fine. I had an abdominal ultrasound, but nothing unusual was noted. A few days later I had a CT scan. They found a few lesions on my liver that they thought were benign liver cysts. Otherwise, nothing was noticed abnormal. I am getting a 2nd opinion currently on the CT scan. I have lost about 20 lbs since the end of May without exercise. I did eat less initially and was doing a lot of walking because my pains bothered me more in bed or sitting than walking.. I think I can justify about half of the 20 lbs, but 20 lbs seems too much without any intentional exercise. I haven't been walking as much in the last month because I don't want to disappear into nothingness, and I have been trying to eat to maintain weight. I have had insomnia and have been restless pretty much the whole time. Initially, my heart rate would bounce around a lot and climb especially after eating. If I waited a while without eating, my heart rate would come back down to near normal. However, just a week ago my resting heart rate went up to 115 bpm in bed. I am not sure why. Before this gastritis event I never had a problem with my heart. I saw the doctor and was put on 10mg Propranalol. My heart rate came down, but the reason for the heart rate sustained spike still concerns me. I do feel like I am occasionally getting random surges of hormones either in my gut/bladder/pelvis. Nothing was noted in a pelvis CT. Not sure how small intestines can be checked. I don't know if an EUS would be helpful to check my pancreas...if that would show more than a CT. Everything else was checked during the colonoscopy or viewed on CT. In addition to the front side pain, I am getting some mostly dry coughing with only a little bit of clear phlegm. I am getting pain under my left breast, sometimes chest pain, pain on the left side at my rib at the bra line. The pain at the rib wraps to my back and goes to my spine. I have soreness up and down my spine. It is worse at the top of my back. My shoulders ache, but my right shoulder blade also tingles. I have tried a muscle relaxer and am doing physical therapy, but it doesn't seem to be improving. I can't remember the last time I was thirsty, either. I pretty much drink according to urine color. All of this since May of this year. I have an appointment with a GI on Monday and a Cardiologist on the following Monday. I am not sure if I should ask for a PET scan to check for adrenaline or other hormone secreting tumors that might have cause my heart to go into inappropriate sinus tachycardia or what I should be asking for next. My cousin is an oncologist, but he is traveling in France and labeled me as anxious some time ago assuming everything is all in my head and has been no help. Please help!
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Follow up: Dr. AJEET SINGH (0 minute later)
I am not sure what to do next. In April, I got a pinching sensation in my mid spine followed by occasional twitching at my sternum. The same evening, I had really bad diarrhea and I felt inflamed for a week before feeling improvement. 3 weeks later, In May, I started to get diarrhea and a burning stomach with bloating and burping. Also, I lost my appetite. I do not have nausea or vomiting and I enjoy food until it bothers my stomach or intestines. The diarrhea comes and goes. The burning has pretty much stopped for now and I have been taking an acid blocker, but I still get bloating and burping. Burping is worse with water and things like "Boost" meal replacement. Sometimes I notice more bloating than other times, but I am burping and bloating every day. I have pretty much been a nervous wreck since the end of May. I got an endoscopy and colonoscopy. They didn't find anything during the colonoscopy, but they found redness in my stomach and lower third of my esophagus during the endoscopy. I had a HIDA scan. Gall bladder is fine. I had an abdominal ultrasound, but nothing unusual was noted. A few days later I had a CT scan. They found a few lesions on my liver that they thought were benign liver cysts. Otherwise, nothing was noticed abnormal. I am getting a 2nd opinion currently on the CT scan. I have lost about 20 lbs since the end of May without exercise. I did eat less initially and was doing a lot of walking because my pains bothered me more in bed or sitting than walking.. I think I can justify about half of the 20 lbs, but 20 lbs seems too much without any intentional exercise. I haven't been walking as much in the last month because I don't want to disappear into nothingness, and I have been trying to eat to maintain weight. I have had insomnia and have been restless pretty much the whole time. Initially, my heart rate would bounce around a lot and climb especially after eating. If I waited a while without eating, my heart rate would come back down to near normal. However, just a week ago my resting heart rate went up to 115 bpm in bed. I am not sure why. Before this gastritis event I never had a problem with my heart. I saw the doctor and was put on 10mg Propranalol. My heart rate came down, but the reason for the heart rate sustained spike still concerns me. I do feel like I am occasionally getting random surges of hormones either in my gut/bladder/pelvis. Nothing was noted in a pelvis CT. Not sure how small intestines can be checked. I don't know if an EUS would be helpful to check my pancreas...if that would show more than a CT. Everything else was checked during the colonoscopy or viewed on CT. In addition to the front side pain, I am getting some mostly dry coughing with only a little bit of clear phlegm. I am getting pain under my left breast, sometimes chest pain, pain on the left side at my rib at the bra line. The pain at the rib wraps to my back and goes to my spine. I have soreness up and down my spine. It is worse at the top of my back. My shoulders ache, but my right shoulder blade also tingles. I have tried a muscle relaxer and am doing physical therapy, but it doesn't seem to be improving. I can't remember the last time I was thirsty, either. I pretty much drink according to urine color. All of this since May of this year. I have an appointment with a GI on Monday and a Cardiologist on the following Monday. I am not sure if I should ask for a PET scan to check for adrenaline or other hormone secreting tumors that might have cause my heart to go into inappropriate sinus tachycardia or what I should be asking for next. My cousin is an oncologist, but he is traveling in France and labeled me as anxious some time ago assuming everything is all in my head and has been no help. Please help!
doctor
Answered by Dr. AJEET SINGH (8 hours later)
Brief Answer:
?MIXED AD SYNDROME

Detailed Answer:
Hi....
Welcome to "Ask a Doctor"service.
I am Dr Ajeet XXXXXXX

I have gone through your query and here is my opinion.

I would agree with your cousin that you are having pathological anxity.

You have been evaluated completely.
This included CT scan,endoscopy,HIDA Scan ,ultrasound etc and all organic causes have been excluded.
Stomach upset,diarrhoea,hyperacidity,significant weight loss,nonspecific pains,insomnia,tachycardia and palpitations all are cardinal signs of Somatization disorder.

There is no harm in going for PET Scan for your mental peace.
Learn relaxation techniques and belly breathing,be physically active,have nourishing diet including plentiful vegetables and fruits,drink a lot of water,get a bit of Sun every day,take commercially available preparations of multivitamin supplements,get counselling and behavioural therapy.
Your symptoms would improve with time.

Happy living.
Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
?MIXED AD SYNDROME

Detailed Answer:
Hi....
Welcome to "Ask a Doctor"service.
I am Dr Ajeet XXXXXXX

I have gone through your query and here is my opinion.

I would agree with your cousin that you are having pathological anxity.

You have been evaluated completely.
This included CT scan,endoscopy,HIDA Scan ,ultrasound etc and all organic causes have been excluded.
Stomach upset,diarrhoea,hyperacidity,significant weight loss,nonspecific pains,insomnia,tachycardia and palpitations all are cardinal signs of Somatization disorder.

There is no harm in going for PET Scan for your mental peace.
Learn relaxation techniques and belly breathing,be physically active,have nourishing diet including plentiful vegetables and fruits,drink a lot of water,get a bit of Sun every day,take commercially available preparations of multivitamin supplements,get counselling and behavioural therapy.
Your symptoms would improve with time.

Happy living.
Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. AJEET SINGH (11 hours later)
I didn't clarify my size or weight. I have lost 14% of my body weight since May without exercise. I was 144.6 lbs 3 months ago, and now I am down to 123 lbs. Does this change your opinion?
default
Follow up: Dr. AJEET SINGH (0 minute later)
I didn't clarify my size or weight. I have lost 14% of my body weight since May without exercise. I was 144.6 lbs 3 months ago, and now I am down to 123 lbs. Does this change your opinion?
doctor
Answered by Dr. AJEET SINGH (18 hours later)
Brief Answer:
?MIXED AD SYNDROME

Detailed Answer:
Hi....
Welcome back.

Clinically significant involuntary weight loss (IWL) is defined as a loss of 4.5 kg over a period of 6 - 12 months, especially when progressive.

Yes.....you have lost too much of weight but in anxiety,panic
disorder,stress,depression and other neurological disorders,
it always happens due to...

1)Impaired desire to eat.
2)Hyper stimulation which affects food absorption.
3)Effect of stress on vagus nerve, which affects how our body digests, absorbs and metabolizes food.
4)Nervous movement burns calories
5)Sleep disruption affects cortisol production which in turn affects metabolism.

I would stick to my opinion.

But,it is not a matter of great worry and there is nothing which can not be salvaged.
Do the life style modifications,dietary changes,get counseling and professional medical help.

Regards.





Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
?MIXED AD SYNDROME

Detailed Answer:
Hi....
Welcome back.

Clinically significant involuntary weight loss (IWL) is defined as a loss of 4.5 kg over a period of 6 - 12 months, especially when progressive.

Yes.....you have lost too much of weight but in anxiety,panic
disorder,stress,depression and other neurological disorders,
it always happens due to...

1)Impaired desire to eat.
2)Hyper stimulation which affects food absorption.
3)Effect of stress on vagus nerve, which affects how our body digests, absorbs and metabolizes food.
4)Nervous movement burns calories
5)Sleep disruption affects cortisol production which in turn affects metabolism.

I would stick to my opinion.

But,it is not a matter of great worry and there is nothing which can not be salvaged.
Do the life style modifications,dietary changes,get counseling and professional medical help.

Regards.




Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. AJEET SINGH

General & Family Physician

Practicing since :1994

Answered : 2151 Questions

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I Am Not Sure What To Do Next. In April,

I am not sure what to do next. In April, I got a pinching sensation in my mid spine followed by occasional twitching at my sternum. The same evening, I had really bad diarrhea and I felt inflamed for a week before feeling improvement. 3 weeks later, In May, I started to get diarrhea and a burning stomach with bloating and burping. Also, I lost my appetite. I do not have nausea or vomiting and I enjoy food until it bothers my stomach or intestines. The diarrhea comes and goes. The burning has pretty much stopped for now and I have been taking an acid blocker, but I still get bloating and burping. Burping is worse with water and things like "Boost" meal replacement. Sometimes I notice more bloating than other times, but I am burping and bloating every day. I have pretty much been a nervous wreck since the end of May. I got an endoscopy and colonoscopy. They didn't find anything during the colonoscopy, but they found redness in my stomach and lower third of my esophagus during the endoscopy. I had a HIDA scan. Gall bladder is fine. I had an abdominal ultrasound, but nothing unusual was noted. A few days later I had a CT scan. They found a few lesions on my liver that they thought were benign liver cysts. Otherwise, nothing was noticed abnormal. I am getting a 2nd opinion currently on the CT scan. I have lost about 20 lbs since the end of May without exercise. I did eat less initially and was doing a lot of walking because my pains bothered me more in bed or sitting than walking.. I think I can justify about half of the 20 lbs, but 20 lbs seems too much without any intentional exercise. I haven't been walking as much in the last month because I don't want to disappear into nothingness, and I have been trying to eat to maintain weight. I have had insomnia and have been restless pretty much the whole time. Initially, my heart rate would bounce around a lot and climb especially after eating. If I waited a while without eating, my heart rate would come back down to near normal. However, just a week ago my resting heart rate went up to 115 bpm in bed. I am not sure why. Before this gastritis event I never had a problem with my heart. I saw the doctor and was put on 10mg Propranalol. My heart rate came down, but the reason for the heart rate sustained spike still concerns me. I do feel like I am occasionally getting random surges of hormones either in my gut/bladder/pelvis. Nothing was noted in a pelvis CT. Not sure how small intestines can be checked. I don't know if an EUS would be helpful to check my pancreas...if that would show more than a CT. Everything else was checked during the colonoscopy or viewed on CT. In addition to the front side pain, I am getting some mostly dry coughing with only a little bit of clear phlegm. I am getting pain under my left breast, sometimes chest pain, pain on the left side at my rib at the bra line. The pain at the rib wraps to my back and goes to my spine. I have soreness up and down my spine. It is worse at the top of my back. My shoulders ache, but my right shoulder blade also tingles. I have tried a muscle relaxer and am doing physical therapy, but it doesn't seem to be improving. I can't remember the last time I was thirsty, either. I pretty much drink according to urine color. All of this since May of this year. I have an appointment with a GI on Monday and a Cardiologist on the following Monday. I am not sure if I should ask for a PET scan to check for adrenaline or other hormone secreting tumors that might have cause my heart to go into inappropriate sinus tachycardia or what I should be asking for next. My cousin is an oncologist, but he is traveling in France and labeled me as anxious some time ago assuming everything is all in my head and has been no help. Please help!