What is wrong with my gut?
August 8, 2019 8:39 AM Subscribe
Everything has been real weird with my guts for the last two months, and I can't figure out what's going on. Details under the cut area little gross, but nothing too graphic.
Ever since the middle of June I've been having a very uncomfortable system - very gassy and intermittent diarrhea. Getting this out of the way immediately: I've had my gallbladder out, my appendix is fine, and all my labs (liver, kidney, basic panel) come back as completely normal. I can't burp or vomit due to a stomach surgery four years ago to fix the top valve of my stomach. This all started off the week I went to the ER with what seemed to be a bursting appendix, but turned out to be some gnarly ovarian cysts.
This pattern repeats weekly.
Day One: I have 8-12 hours of increasingly uncomfortable bloating with gas that clears the room. It's enough to keep me up at night. I have some discomfort in a few spots along my intestines, but the pockets of ouch seem to move along with the gas. The farts really smell like something died in there. GasX doesn't seem to do much. The next morning, I feel OK. Not back to normal, but not in crazy discomfort anymore.
Day Two: But in the middle of the afternoon about six hours later, I have explosive diarrhea. It's generally shortly after eating. It clears everything in my guts out, and leaves me sweaty and shaky. It doesn't stop until I take a imodium. (I've tested. I'll just keep heading back to the bathroom until I take one.)
Days 3/4: After I take the imodium, I have a couple days of an uncomfortable and gurgly stomach. Water tastes horrible, and I have to resort to tea and gatorade to stay hydrated because I can't force myself to drink water. (This is unusual since I'm usually a big water drinker and rarely have anything sugary like gatorade.)
Day 5-7: of the cycle, everything is fine. My bowels are moving pretty normally, and I'm not really gassy anymore. I'm not super hungry, but eating doesn't hurt. Things are fine until BAM like clockwork, a week after the cycle started it's back.
I have managed to move the explosive diarrhea to Monday morning instead of Saturday afternoon by delaying taking the imodium. I tend to be fairly sensitive to medications, and it has always taken me about a week to get back to normal after taking imodium. So, apparently my normal right now is deadly sulphury gas and explosive diarrhea. I'm confident that it's not the imodium causing it, it's just masking the symptoms during the week for me.
During the first couple days after I take the imodium, my stool is greenish like it has bile. So, I tried a low fat diet, in case it was the absence of my gallbladder acting up. (I had it out some years ago, but I know occasionally people will have bouts of trouble later. I figure it was worth trying.) It will also sometimes have a fair amount of white mucous.
I'm a vegetarian, definitely not celiac. I've tried adding fiber, taking fiber out, eating more protein, cutting out sugar, cutting out caffeine, eating more protein, eating less protein.... You get the idea. I am a generally very healthy eater, and I can't figure out what my stomach wants. I'm really sick of the cramping and gastric dumping. I can't be absorbing nutrients well right now, and I'm starting to get a little befuddled in my thinking because of it. Any ideas? Did I pick a weird bug up at the ER two months ago?
Ever since the middle of June I've been having a very uncomfortable system - very gassy and intermittent diarrhea. Getting this out of the way immediately: I've had my gallbladder out, my appendix is fine, and all my labs (liver, kidney, basic panel) come back as completely normal. I can't burp or vomit due to a stomach surgery four years ago to fix the top valve of my stomach. This all started off the week I went to the ER with what seemed to be a bursting appendix, but turned out to be some gnarly ovarian cysts.
This pattern repeats weekly.
Day One: I have 8-12 hours of increasingly uncomfortable bloating with gas that clears the room. It's enough to keep me up at night. I have some discomfort in a few spots along my intestines, but the pockets of ouch seem to move along with the gas. The farts really smell like something died in there. GasX doesn't seem to do much. The next morning, I feel OK. Not back to normal, but not in crazy discomfort anymore.
Day Two: But in the middle of the afternoon about six hours later, I have explosive diarrhea. It's generally shortly after eating. It clears everything in my guts out, and leaves me sweaty and shaky. It doesn't stop until I take a imodium. (I've tested. I'll just keep heading back to the bathroom until I take one.)
Days 3/4: After I take the imodium, I have a couple days of an uncomfortable and gurgly stomach. Water tastes horrible, and I have to resort to tea and gatorade to stay hydrated because I can't force myself to drink water. (This is unusual since I'm usually a big water drinker and rarely have anything sugary like gatorade.)
Day 5-7: of the cycle, everything is fine. My bowels are moving pretty normally, and I'm not really gassy anymore. I'm not super hungry, but eating doesn't hurt. Things are fine until BAM like clockwork, a week after the cycle started it's back.
I have managed to move the explosive diarrhea to Monday morning instead of Saturday afternoon by delaying taking the imodium. I tend to be fairly sensitive to medications, and it has always taken me about a week to get back to normal after taking imodium. So, apparently my normal right now is deadly sulphury gas and explosive diarrhea. I'm confident that it's not the imodium causing it, it's just masking the symptoms during the week for me.
During the first couple days after I take the imodium, my stool is greenish like it has bile. So, I tried a low fat diet, in case it was the absence of my gallbladder acting up. (I had it out some years ago, but I know occasionally people will have bouts of trouble later. I figure it was worth trying.) It will also sometimes have a fair amount of white mucous.
I'm a vegetarian, definitely not celiac. I've tried adding fiber, taking fiber out, eating more protein, cutting out sugar, cutting out caffeine, eating more protein, eating less protein.... You get the idea. I am a generally very healthy eater, and I can't figure out what my stomach wants. I'm really sick of the cramping and gastric dumping. I can't be absorbing nutrients well right now, and I'm starting to get a little befuddled in my thinking because of it. Any ideas? Did I pick a weird bug up at the ER two months ago?
It's time to see a gastroenterologist.
posted by Automocar at 8:49 AM on August 8, 2019 [26 favorites]
posted by Automocar at 8:49 AM on August 8, 2019 [26 favorites]
I would work toward seeing a specialist, but a cheap test you can do in the meantime, assuming your surgery doesn't contraindicate: Tagamet (cimetidine), 200mg twice a day (12 hour interval). Try it for a week, try stopping the immodium if you can (it can rebound, which might explain the cyclical nature of your issue), try adding in a probiotic supplement.
posted by Lyn Never at 8:59 AM on August 8, 2019
posted by Lyn Never at 8:59 AM on August 8, 2019
Do you eat dairy? A trial of no dairy for at least 10 days is not that hard. I have similar, milder effects from dairy. I can't eat milk, cheese, yogurt, butter, even aged cheeses.
posted by theora55 at 8:59 AM on August 8, 2019 [2 favorites]
posted by theora55 at 8:59 AM on August 8, 2019 [2 favorites]
Automocar has the only answer. Get a referral to a GI specialist. My dad has ulcerative colitis and he would identify with so much of what you've been through, but only a doctor can tell you for sure.
posted by futureisunwritten at 9:01 AM on August 8, 2019 [3 favorites]
posted by futureisunwritten at 9:01 AM on August 8, 2019 [3 favorites]
Your best bet is to go see a GI. They may have you do elimination diets, bloodwork, and they might eventually do a colonoscopy, endoscopy or both. I went down this rabbit hole for GI issues a few years ago and eventually got diagnosed with IBS but they will rule out all the other major scary stuff first.
posted by FireFountain at 9:01 AM on August 8, 2019 [1 favorite]
posted by FireFountain at 9:01 AM on August 8, 2019 [1 favorite]
I'm going to say something scary. I apologize in advance, but I have to say it. Please get to a gynecologist for an ultrasound. Ovarian cancer can present with exactly this sort of GI thing -- "digestion issues" that can keep women from being diagnosed properly for a very long time. I watched it happen with my best friend -- running down all sorts of path to try to figure out what was going on with her digestion, with her bowels, etc. All that diarrhea and constipation was clearly related to her diet or an allergy or something...except it was ovarian cancer.
The "basic panel" you're getting an okay on may or may not include a CA-125 test (the ovarian cancer test) but not all ovarian cancer shows up in CA-125.
posted by BlahLaLa at 9:06 AM on August 8, 2019 [10 favorites]
The "basic panel" you're getting an okay on may or may not include a CA-125 test (the ovarian cancer test) but not all ovarian cancer shows up in CA-125.
posted by BlahLaLa at 9:06 AM on August 8, 2019 [10 favorites]
I'm thinking giardia, but only your GI specialist is actually going to be able to give you a diagnosis that means anything.
It's a pity you can't burp, because burps that smell damn different from but every bit as bad as the farts were a tell for me when I got it.
posted by flabdablet at 9:08 AM on August 8, 2019 [5 favorites]
It's a pity you can't burp, because burps that smell damn different from but every bit as bad as the farts were a tell for me when I got it.
posted by flabdablet at 9:08 AM on August 8, 2019 [5 favorites]
I came to suggest giardia, too, although it doesn't tend to ebb and flow in the way you mentioned. It may also be another kind of infection, perhaps something bacterial that can be cultured and treated fairly easily (and, yes, hospital-acquired C. diff etc. is a possibility here). But, yes, it's time to talk to at least a GP.
posted by late afternoon dreaming hotel at 10:14 AM on August 8, 2019
posted by late afternoon dreaming hotel at 10:14 AM on August 8, 2019
This all started off the week I went to the ER with what seemed to be a bursting appendix, but turned out to be some gnarly ovarian cysts.
Please investigate with both a gastroenterologist and a gynecologist.
posted by ocherdraco at 10:17 AM on August 8, 2019 [8 favorites]
Please investigate with both a gastroenterologist and a gynecologist.
posted by ocherdraco at 10:17 AM on August 8, 2019 [8 favorites]
Any chance you are taking melatonin to sleep? Apparently it is not a common side effect but it got me going like, whoa. I finally figured it out and stopped taking it and it took over a week to get mostly normal again.
posted by onebyone at 11:04 AM on August 8, 2019
posted by onebyone at 11:04 AM on August 8, 2019
I had the same scary thought as BlahLaLa based on a friend's experience. Her doctor dismissed it as hysterical (ha!) overreaction, possibly associated with approaching menopause. She eventually insisted on referral to a specialist who diagnosed, just in time to allow for treatment. I very sincerely hope that's not your story, but it shouldn't be ignored.
posted by RandlePatrickMcMurphy at 11:20 AM on August 8, 2019 [1 favorite]
posted by RandlePatrickMcMurphy at 11:20 AM on August 8, 2019 [1 favorite]
I agree with seeing a GI and probably a gynecologist. While you’re waiting, start tracking everything you put in your mouth - food, drinks, meds, even toothpaste and floss. If the GI and gynecologist clear you of the scary stuff, you’ll have a good log to start looking for food allergies (which were the first thing that came to mind with such a week-long cyclical pattern, especially if you’re eating the same thing on Day 1 every time).
posted by bananacabana at 12:34 PM on August 8, 2019 [2 favorites]
posted by bananacabana at 12:34 PM on August 8, 2019 [2 favorites]
Even if you didn't have celiac before, it can be triggered as an adult especially after illness or injury. Get a blood test unless you've already had one since this started. It happened to me, and I wasn't able to associate it with the timing of anything I ate.
posted by lookoutbelow at 1:30 PM on August 8, 2019 [1 favorite]
posted by lookoutbelow at 1:30 PM on August 8, 2019 [1 favorite]
Definitely the doctor. They might send you home with a stool sample kit which is a relatively easy process. The water not tasting right.. how does it taste bad? All kinds and temperatures taste bad in the same way? That could be caused by the immodium?, but that would bother me a lot.
posted by OnTheLastCastle at 2:52 PM on August 8, 2019 [1 favorite]
posted by OnTheLastCastle at 2:52 PM on August 8, 2019 [1 favorite]
Yeah, it's time to go back to the doctor. Ask for a stool test and I would try to see both a GI specialist and a gynecologist. The random diarrhea sounds kind of like a time I had an amoeba infection, but you need medical help. Tracking everything you eat and the timing of your symptoms might help your doctors, so go ahead and do that too.
posted by purple_bird at 3:56 PM on August 8, 2019
posted by purple_bird at 3:56 PM on August 8, 2019
I liked this book as a way to think through symptoms. The Bloated Belly Whisperer by Tamara Duker Freuman. It was way less irritating than most of this genre.
posted by spamandkimchi at 4:24 PM on August 8, 2019
posted by spamandkimchi at 4:24 PM on August 8, 2019
Did you get an ultrasound for the ovarian cysts? Ovarian issues can definitely present as GI upset and/or pain.
Please see a gynecologist as well as a gastroenterologist.
posted by lydhre at 5:41 PM on August 8, 2019
Please see a gynecologist as well as a gastroenterologist.
posted by lydhre at 5:41 PM on August 8, 2019
I'm definitely in agreement with everyone else on getting to a doctor to rule out gynecology issues as well as seeing a specialist about GI stuff.
One possibility is people who have IBS issues and do not have celiac sometimes can attribute symptoms to eating high FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) foods. Definitely start tracking what you eat. If you're having major gastrointestinal upset, it's possible what you're eating is responsible for it. Even if it's not the FODMAP stuff specifically.
It doesn't track with the cycling you seem to be experiencing, unless the foods you are eating are also on a cycle that may play into this....or, if you are reducing your meals when you're not feeling well, giving time for your body heal, only to be upset again once you return to the same things (and quantities) you had been eating. FODMAP foods are cumulative. The more of them you eat, the worse you feel.
A completely separate thought....how long ago did you have your gallbladder out? Could it be this: Postcholecystectomy syndrome? The link specifically mentions bile acid diarrhea.
posted by pdxhiker at 8:15 PM on August 8, 2019
One possibility is people who have IBS issues and do not have celiac sometimes can attribute symptoms to eating high FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) foods. Definitely start tracking what you eat. If you're having major gastrointestinal upset, it's possible what you're eating is responsible for it. Even if it's not the FODMAP stuff specifically.
It doesn't track with the cycling you seem to be experiencing, unless the foods you are eating are also on a cycle that may play into this....or, if you are reducing your meals when you're not feeling well, giving time for your body heal, only to be upset again once you return to the same things (and quantities) you had been eating. FODMAP foods are cumulative. The more of them you eat, the worse you feel.
A completely separate thought....how long ago did you have your gallbladder out? Could it be this: Postcholecystectomy syndrome? The link specifically mentions bile acid diarrhea.
posted by pdxhiker at 8:15 PM on August 8, 2019
I’d definitely check out the gyno thing just to be safe but I’m leaning towards parasites.
posted by Jubey at 9:49 PM on August 8, 2019
posted by Jubey at 9:49 PM on August 8, 2019
It would probably help when talking to the doctor to say, if you really think the "cyclic" nature is just Imodium-based, "it only lets up for a few days after I take an Imodium, and then it comes back" rather than describing the problem itself as having a weekly cycle.
At least, from your description that's how I'd be inclined to think of it, and it sounds like you think that's an accurate description too.
posted by Lady Li at 12:58 AM on August 9, 2019 [1 favorite]
At least, from your description that's how I'd be inclined to think of it, and it sounds like you think that's an accurate description too.
posted by Lady Li at 12:58 AM on August 9, 2019 [1 favorite]
A friend of mine had increasingly awful gut issues in the years following removal of her gall bladder--to the point where she had nearly constant diarrhea, Imodium several times a day, fearful that she'd become incontinent in the bowel. Several docs didn't help but then one put her on an oral suspension of cholestyramine and it turned things around completely. Prior doctors didn't make the connection to her gall bladder removal but the one who did said that it's extremely common to overlook and that many cases that are diagnosed as IBS are really related to bile stuff. Since that's in your history as well, another possibility to consider. Good luck.
posted by Sublimity at 3:46 AM on August 9, 2019 [1 favorite]
posted by Sublimity at 3:46 AM on August 9, 2019 [1 favorite]
Mod note: From the OP:
Went to the doctor this morning, giardia is her guess, too! Starting the testing for giardia, c diff and cryptosporidium. Turns out they're not at all as rare as I had thought. I'll be following up with an ob/gyn on Monday. Thank you to everyone for your help and the push to go see someone. Well, several someones. For future readers - if your pain level is holding at 6 or 7 every day, don't wait two months to go see a doctor. I'll ask the mods to update if I get a clear answer.posted by restless_nomad (staff) at 11:21 AM on August 9, 2019 [3 favorites]
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