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I Am Wondering If My Issues That My GI Cannot
Posted on
Tue, 17 Mar 2020
Tue, 17 Mar 2020
Answered on
Last reviewed on
Question :
I am wondering if my issues that my GI cannot figure out could somehow be endocrinology related. My aunt has told me she had similar symptoms and it was the "glands on her kidneys" She said she had to do specialized lab work that was drawn 3 hours apart and took a few days to come back and is on steroid treatment. She does not know what the actual disease name is called. My mother (deceased) also had similar issues as a kid which led her to pass out as did my grandfathers mother from what i'm being told. I am trying to look outside the box because no one has any answers for me on my team. One physician suggested porphyria but I have not yet been tested.
I had a lap for endometriosis in early January. Procedure went fine and the day before I got sick I felt really good. On day 4 post op was the beginning of a mystery nightmare that no one has been able to figure out. Since then I have had 3 'episodes/flares' of violent nausea/vomiting/diarrhea/cold chills/extreme fatigue with palpitations/high heat rate at onset, the first lasted 8 days (with an additional 2 days that weren't great before discharge, then an entire 2+ weeks that I could barely function or drive at home from fatigue), the 2nd lasted 5/6 days at the worst and an additional 2 days that weren't great. and i'm on day 4 of the 3rd. With the surgery, and these episodes I have been in/out of the hospital over 20 days out of the last 3 months and no one really has any ideas that have panned out. GI, neurology, the surgeon who performed the procedure, multiple hospitalists, my rhuematologist, PCP. 2 seperate Abdomen Pelvic CT were normal, blood work mostly normal on day 1 of the issues I will have elevated WBC/neutrophils but resolves on its own. MRCP normal. Brain CT & MRI normal. Endoscopy was negative for anything explanatory. Thyroid normal. Medication does not control the nausea/vomiting including 8mg of zofran/reglan/ativan/benadryl. Even in IV form. I have never felt this bad in my entire life.
Symptoms (1st episode):
Severe nausea (disabling)
Vomiting green bile & dry heaving
Legs twitching/hot/cold chills
Diarrhea (mostly yellow/foam)10-20x a day
I felt disoriented/weak
Ears were ringing so loud
Palpitations
Vision was off
Brain fog
Elevated WBC and neutrophils day 1 (Started to go down day 2)
And the worst symptom of all was that When the violent nausea would hit I would get so tired/out of it that I could not physically keep my eyes open.
Urine was getting darker during 2nd admission I remember the hospitalist looked at it and he thought it was so weird with me having been on fluids for so many days continuously.
Symptoms (2nd episode)
Diarrhea 2-3 days prior to onset, did have a really bad headache 1 day prior to onset
Severe nausea (disabling)
Vomiting green bile & dry heaving
Palpitations high heart rate at onset 130-150s
Legs twitching/hot/cold chills
Diarrhea during episode 5-7 times per day
Elevated WBC and neutrophils day 1
Mild ear ringing
Weak and mildly disoriented-less so than last time.
Some low center pain, moderate that would wake me up, partially relieved by bowel movement
Symptoms (3rd Episode)
Headaches worse than my normal 2-3 days before onset.
Diarrhea during episode about 5-6x/day on average
Palpitations but did not notice it was extremely high at onset like before
Severe nausea
Vomiting green bile/dry heaving
Legs less twitchy but just feel really weird/annoying.
Cold chills (cannot stay warm no matter what, shivering wakes me up)
Ears still ringing/sensitive
Weak but less disoriented feeling than before
Just feel really really bad
Normal WBC on Day 2 (no labs done day 1)
More stomach pain on/off than I had with the initial 2 episodes Mostly RUQ and low abdomen.
I am wondering if my issues that my GI cannot figure out could somehow be endocrinology related. My aunt has told me she had similar symptoms and it was the "glands on her kidneys" She said she had to do specialized lab work that was drawn 3 hours apart and took a few days to come back and is on steroid treatment. She does not know what the actual disease name is called. My mother (deceased) also had similar issues as a kid which led her to pass out as did my grandfathers mother from what i'm being told. I am trying to look outside the box because no one has any answers for me on my team. One physician suggested porphyria but I have not yet been tested.
I had a lap for endometriosis in early January. Procedure went fine and the day before I got sick I felt really good. On day 4 post op was the beginning of a mystery nightmare that no one has been able to figure out. Since then I have had 3 'episodes/flares' of violent nausea/vomiting/diarrhea/cold chills/extreme fatigue with palpitations/high heat rate at onset, the first lasted 8 days (with an additional 2 days that weren't great before discharge, then an entire 2+ weeks that I could barely function or drive at home from fatigue), the 2nd lasted 5/6 days at the worst and an additional 2 days that weren't great. and i'm on day 4 of the 3rd. With the surgery, and these episodes I have been in/out of the hospital over 20 days out of the last 3 months and no one really has any ideas that have panned out. GI, neurology, the surgeon who performed the procedure, multiple hospitalists, my rhuematologist, PCP. 2 seperate Abdomen Pelvic CT were normal, blood work mostly normal on day 1 of the issues I will have elevated WBC/neutrophils but resolves on its own. MRCP normal. Brain CT & MRI normal. Endoscopy was negative for anything explanatory. Thyroid normal. Medication does not control the nausea/vomiting including 8mg of zofran/reglan/ativan/benadryl. Even in IV form. I have never felt this bad in my entire life.
Symptoms (1st episode):
Severe nausea (disabling)
Vomiting green bile & dry heaving
Legs twitching/hot/cold chills
Diarrhea (mostly yellow/foam)10-20x a day
I felt disoriented/weak
Ears were ringing so loud
Palpitations
Vision was off
Brain fog
Elevated WBC and neutrophils day 1 (Started to go down day 2)
And the worst symptom of all was that When the violent nausea would hit I would get so tired/out of it that I could not physically keep my eyes open.
Urine was getting darker during 2nd admission I remember the hospitalist looked at it and he thought it was so weird with me having been on fluids for so many days continuously.
Symptoms (2nd episode)
Diarrhea 2-3 days prior to onset, did have a really bad headache 1 day prior to onset
Severe nausea (disabling)
Vomiting green bile & dry heaving
Palpitations high heart rate at onset 130-150s
Legs twitching/hot/cold chills
Diarrhea during episode 5-7 times per day
Elevated WBC and neutrophils day 1
Mild ear ringing
Weak and mildly disoriented-less so than last time.
Some low center pain, moderate that would wake me up, partially relieved by bowel movement
Symptoms (3rd Episode)
Headaches worse than my normal 2-3 days before onset.
Diarrhea during episode about 5-6x/day on average
Palpitations but did not notice it was extremely high at onset like before
Severe nausea
Vomiting green bile/dry heaving
Legs less twitchy but just feel really weird/annoying.
Cold chills (cannot stay warm no matter what, shivering wakes me up)
Ears still ringing/sensitive
Weak but less disoriented feeling than before
Just feel really really bad
Normal WBC on Day 2 (no labs done day 1)
More stomach pain on/off than I had with the initial 2 episodes Mostly RUQ and low abdomen.
Brief Answer:
Functional nausea.
Detailed Answer:
Hi
I have gone through your query.
I can understand your concern.
Considering that all your test results are normal(lab test,CT,MRI of head, abdomen and endoscopy all normal) we can deduce that your nausea and vomiting are idiopathic.
Chronic idiopathic nausea is characterized by nausea occurring several times per week in the absence of an identifiable organic cause.
(like in your case)
1.When the test results dont show an identifiable organic cause that explain your symptoms we can say that you may have Functional gastrointestinal symptoms((FGI symptoms).These symptoms produce dehydration and electrolite imbalance that can explain fatigue,muscle swiching and palpitations.
Functional gastrointestinal disorders are common disorders that are characterized by persistent and recurring GI symptoms. These is a possible diagnosis is your circomstances.
2.Acute Porphyria this also is a possible diagnosis in your case because it can explain some of your symptoms like abdominal pain,nausea,vomitong,muscle tingling,brown urine and disoriented feeling.
In these cases laboratory tests are done on urine samples taken during the attack.Attacks are treated by giving glucose and sometimes heme.
I suggest to talk with your local doctor about these lab test to confirm or exclude the diagnosis of Porphyria.
Maintaining good nutrition and avoiding alcohol and drugs that trigger attacks are important when the diagnosis is confirmed.
3.Endocrine causes that can explain your symptoms are hypercalcaemia, hypothyroidism and XXXXXXX disease.
Hypothyroidism is excluded because your thyroid test are within the range.
I suggest to talk with your local doctor about the test that check for hypercalcemia and XXXXXXX disease.(calcium test,PTH test,morning cortisolemia and ACTH level:sodium and potasium level)
Hope this is helpful.
Wish you good health.
Functional nausea.
Detailed Answer:
Hi
I have gone through your query.
I can understand your concern.
Considering that all your test results are normal(lab test,CT,MRI of head, abdomen and endoscopy all normal) we can deduce that your nausea and vomiting are idiopathic.
Chronic idiopathic nausea is characterized by nausea occurring several times per week in the absence of an identifiable organic cause.
(like in your case)
1.When the test results dont show an identifiable organic cause that explain your symptoms we can say that you may have Functional gastrointestinal symptoms((FGI symptoms).These symptoms produce dehydration and electrolite imbalance that can explain fatigue,muscle swiching and palpitations.
Functional gastrointestinal disorders are common disorders that are characterized by persistent and recurring GI symptoms. These is a possible diagnosis is your circomstances.
2.Acute Porphyria this also is a possible diagnosis in your case because it can explain some of your symptoms like abdominal pain,nausea,vomitong,muscle tingling,brown urine and disoriented feeling.
In these cases laboratory tests are done on urine samples taken during the attack.Attacks are treated by giving glucose and sometimes heme.
I suggest to talk with your local doctor about these lab test to confirm or exclude the diagnosis of Porphyria.
Maintaining good nutrition and avoiding alcohol and drugs that trigger attacks are important when the diagnosis is confirmed.
3.Endocrine causes that can explain your symptoms are hypercalcaemia, hypothyroidism and XXXXXXX disease.
Hypothyroidism is excluded because your thyroid test are within the range.
I suggest to talk with your local doctor about the test that check for hypercalcemia and XXXXXXX disease.(calcium test,PTH test,morning cortisolemia and ACTH level:sodium and potasium level)
Hope this is helpful.
Wish you good health.
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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