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Suffering From Churg-strauss Syndrome, Sjogren's Syndrome And Chronic Abdominal Distention. What Treatment Should Be Done?

Posted on Thu, 18 Oct 2012

Question: I have chronic abdominal distention that I watch and feel every day of my life, when I blw up like a Mylar ballon. My GI dr. Just blames it on the fact that I get IBS from time to time. No one ha an answer. 69 yr old female with autoimmune problems, such as Churg-Strauss and Sjogren's. The distention is worsening and my weight is increasing. Very depressing.

Answered by Dr. Dr.P.Ratnakar Kini (23 minutes later)

Hi,
I am Dr.Ratnakar Kini, Gastroenterologist and I am pleased to answer your question.
Distension of the abdomen could be due to gas, fluid or increased fat.

I would like to have some more information before I can give my opinion.

1. How long have you been having this abdominal distension?

2. Does it worsen after food?

3. What medications you are on?

4. What tests have been done so far for this symptom?

5. Are you a diabetic?

6. Any loss of weight?

Kindly get back to me with the answers and I would give my opinion.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (10 hours later)

1.) chronically about a year, before that it all started I got the distention after a morning normal bowel movement, but then it would go away. 2.) yes, it does worsen after I eat meals. Incidentally, we eat very healthy. Not hardly any fat, eat fish, and skinless chicken, salads and veggies. Never fried foods!...3.) other than daily meds listed like prednisone, I have a prescription for 20 mgs omeprazole as needed. Very important that I've been on amitiza only 8 mgs 1 tablet at nighttime for 3 yrs. .....
4.) I've recently had the hydrogen breath test for bacterial overgrowth and negative it was. Have also had lactose intolerant which was fine too. Although I don't do much dairy at all. 5.) I am not diabetic and this year I stay around 149, 150 lbs. always stayed at 140-142 since I got Chug-Strauss and even yrs. before. I had to quit taking Amitiza recently due to not bing able to afford it. I'm in the gap Coverage with Medicare Advantage.
Thanks Dr. Kini.

Answered by Dr. Dr.P.Ratnakar Kini (16 hours later)

Hi,
Thanks for providing the information I wanted.

IBS is not usually diagnosed in an individual who is 69 years old. Moreover your symptoms are not suggestive of IBS.

Abdominal distension could be due increased gas, fluid accumulation in the abdomen or increased fat in the abdominal wall.

Amitiza itself is known to cause abdominal distension. But since you have stopped taking it, it is unlikely to be the cause.

I would suggest you discuss with your doctor for tests like upper GI endoscopy and ultrasound scan of the abdomen for further evaluation.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (9 hours later)

Dr. Kini, you have touched on things that (2) GI drs. have ignored me on. Here's how my day starts: eat fiber like cereal, oatmeal, drink 1 mug Low Acid coffee (I have interstitial cystitis ) then after a near perfect bowel movement I can watch my abdomen blow up ith pressure (as I write) up under my ribs). Would a blood flow problem due to inactive vasculitis cause increased gas or fluid buildup? And no, my Dr. At Wake Forest Baptist in NC, avoids questions on giving me upper GI endoscopy and/or ultrasound scan. You have given me great info and you did understand that I definitely have ( in remission) Churg-Strauss and Sjogren's Syndrome (tht being secondary to CS). Thank you so much, Dr. Kini, and could you give me one last reply on this---think this is my 2nd question I am due.

Answered by Dr. Dr.P.Ratnakar Kini (22 hours later)

Hi,
Vasculitis can very rarely cause fluid accumulation in the abdomen causing abdominal distension.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (7 hours later)

Dr. Kini, my GI dr. Did say that he wants to do this colonoscopy because I had "a more serious kind of polyp in 1998 XXXXXX( my 1st colonoscopy). Had one 5yrs ago too. (no polyp tho). Now, all this distention is so recent and truthfully I'm afraid of colon perforation, as I had my bladder perforated last Dec. How much can really be found out in the abdominal cavity with a colonoscopy?? I know there are umpteen causes for this abdom. distention, so shd I ask like you said for ultrasound, etc. first? Would you believe that I had 3 surgeries this month for badal cell cancer in nose, so I've recently had 2 general anesthesias... Colonoscopy, Oct. 19th. Thanks a bunch, XXXXXX

Answered by Dr. Dr.P.Ratnakar Kini (14 hours later)

Hi,
Colonoscopy is a test with which only the inside of the colon can be seen and not the abdominal cavity.
Yes , ultrasound scan may be done for that.

Does that answer your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar