Help, I'm In An Abusive Relationship With My Innards
May 3, 2011 12:31 PM   Subscribe

I've been a puking, painful sulfur factory for a month and a half. All my test results have been negative, and my GP is stumped. Wondering if anyone's experienced similar and can clue me in about what I have. Warning: Gross.

Backstory: Since I was a teenager, I’ve had these weird “attacks” that hit every few years.

It always starts the same way: I start burping up gas that tastes like sulfur / rotten eggs. A few hours later, I get really ill: stabbing lower-abdominal cramps and extreme amounts of gas that I can’t pass fast enough to prevent pain. Over-the-counter gas medications only help a fraction.

Eventually, this is followed by explosive diarrhea and vomiting. Everything coming out of me reeks so strongly of sulfur that the whole house ends up smelling like brimstone. These attacks would only last one-two days. I stopped going to the doctor for them because every time I did, they’d never find anything wrong with me and say it must be a viral infection.

The pain is bad enough that when my daughter came prematurely, I didn’t go to the hospital until I was twelve hours into labor because I thought I was just having another attack of this.

On March 24th, my stepson was visiting his grandmother overnight when he came down with what seemed like food poisoning: vomiting, diarrhea and pain. A few hours after she called to tell me, I got the sulfur burps. Soon I was as bad off as he was... but while he got better in a day, I’m still not over it 41 days later. It’s exactly like the attacks I used to have, but it won’t go away.

Or rather, it won’t stay away. I get violently ill for a day or two, and then I feel better for another day or two, then sick again. Over time, the severity has decreased... I was okay all last week and really thought I was done, then got the sulfur burps last night and woke up puking this morning. I’ve thrown up 14 times today so far. There’s no nausea involved... I just randomly puke, especially if I’ve done something like cough. Chills, exhaustion, etc. It's not awesome.

Five people live in our house, three of whom (toddler daughter, stepson, elderly relative) are with me 24/7 (I homeschool). Only the stepson has ever gotten sick, before I did, and just the once. If this was a contagious virus, it seems bizarre that my toddler hasn’t gotten it, since I have more physical contact with her than anyone and she never met a germ she didn’t want to stick in her mouth.

My husband is showing some symptoms: he’s had cramps and diarrhea off and on for two weeks, but no vomiting or pain, and a few nights ago I noticed that his breath was reeking of sulfur in his sleep.

I have Googled like a madman, and the only thing that seems to fit my symptoms is Giardiasis... however, my stool ova and parasites exam (and every other test they ran on me) came back negative. I think I may have screwed up my sample, though. You probably don't want details on that.

There is zero chance that I am pregnant, and it seems very unlikely that I’m repeatedly food-poisoning myself... all the food in the house has changed, and I was still just as sick the week+ I didn’t consume anything but bottled Gatorade.

Has anyone else had something similar and been treated for it? I have another appointment with my general practitioner tomorrow, but I’m not sure what he can do for me when every test has come back negative. So far he's said it's just a virus and to wait for it to pass. Should I ask for a referral to a specialist, and if so, what kind?

Thanks in advance :)
posted by Gianna to Health & Fitness (22 answers total) 2 users marked this as a favorite
You need to see a gastroenterologist, and you need to insist on real treatment. Don't let them tell you it's a viral infection without finding out what virus and how to treat it. Frankly, if this has been going on for more than a month, it's an emergency. You need help, it's your doctors' job to provide it, and you should insist that they do.
posted by decathecting at 12:41 PM on May 3, 2011 [10 favorites]

This sounds like a waterborne organism, what sort of water supply do you use?
posted by hortense at 12:43 PM on May 3, 2011

Yeah, you need a referral to a gastroenterologist. If you think you messed up your stool sample, you might want to do it again.
posted by the young rope-rider at 12:45 PM on May 3, 2011

A similar question has come up before. Have you been tested for helicobacter pylori?
posted by Mr.Know-it-some at 12:49 PM on May 3, 2011 [1 favorite]

IANAD....maybe a specialist who can check your pancreas? A friend of my parents suffered pain and gas after meals for years, and then things got worse--cant remember how. After many specialists, it turned out to be something about a duct in his pancreas.

I'm sorry I don't remember much about it. I'll ask my parents.
posted by vitabellosi at 12:55 PM on May 3, 2011

I've had these same symptoms. My doctor prescribed high doses of Omeprazole, which is available over the counter as Prilosec, on the theory that reducing stomach acid would allow my GI tract to heal whatever was causing the issue.

I was dubious, as I expected it was bacterial and that antibiotics were in order.

But it worked. Haven't had an episode since then. And I've nominated this doctor for sainthood.
posted by Cool Papa Bell at 12:58 PM on May 3, 2011 [3 favorites]

Seconding seeing a gastroenterologist -- I'm surprised your GP hasn't long since given you a referral to one (at least it sounds from your post that he/she hasn't done this). This is really getting into specialist's territory.

When you say you've had tests run, are you just talking blood and stool tests? Have you had an upper endoscopy and/or a colonoscopy?

Beyond gastrointestinal stuff, it also makes me wonder about your gall bladder or your pancreas. But yeah, first things first: you must see a gastroenterologist if your GP is "stumped."
posted by scody at 1:20 PM on May 3, 2011 [1 favorite]

I had symptoms like these when I was a teenager. Never received a diagnosis, but my doctor insisted they were stress-related, and I was checked for ulcers (didn't have any). They certainly did always crop up during times when I was anxious or stressed out. (I have never experienced it as an adult.)
posted by hermitosis at 1:22 PM on May 3, 2011

IANAD but I am a biochemist. I'm fairly sure there's not a way for your body to suddenly start pumping out organosulfide gasses. Given that its slowly spreading, you may have some unusual gut flora that are being passed around.

As with the other suggestions, get the doctor to redo the test AND refer you to a gastroenterologist.
posted by Slackermagee at 2:43 PM on May 3, 2011

Since you have had some of these symptoms over the years, but usually with much less frequency/intensity than you have been experiencing, I'm thinking that you have a couple things going on: diverticulitis, food allergy/sensitivity (like Crohn's or Celiac disease) or a partial intestinal obstruction that is giving you those intermittent symptoms AND some kind of viral or bacterial thing going on that's aggravating that right now.

Which would explain why your husband has symptoms, but not any as severe as yours, since he doesn't have an underlying condition making this thing worse.

Definitely see a gastroenterologist or internal medicine specialist! Get that testing redone, if you need to, and also have them take an ultrasound at some point to determine what this lingering situation you've been dealing with for years might be.

In the meantime, though usually fiber is a good thing, you want to keep your fiber intake low and avoid starchy or sugary foods, in case your underlying, ongoing condition is food-based, like lactose intolerance, Crohn's or Celiac disease. When you can eat and keep some down, a food journal could really help you pinpoint what is affecting you.

Good luck. This sounds absolutely miserable, and I feel for you, especially with little ones to watch at home, too!
posted by misha at 3:24 PM on May 3, 2011

I had something like that. It was giardia. I would exude sulfur from my skin, like garlic. The first bout of giardia mimicked malaria - GI problems coupled with a fever high enough to cause hallucinations coming on in the space of about 12 hours. Malaysian doc put me on something that made me better enough for travel overnight and then I had bouts of sulfur smell with GI distress without a fever every few weeks until we finally got it killed, a year later.

Giardia is hard to ID - we never managed to find cysts but the sulfur smell coupled with my having been out of the country and having abruptly lost ten pounds in the space of a couple of months was enough for my trained-in-a-developing-country-back-in-the-US GP doc. You need to catch the infection at the right stage in its life cycle but that's a challenge for the obvious reasons. There are other things they can do to identify since it's hard to find cysts. Seconding or thirding the time to go to a specialist.

Giardia is hard to kill - it took four rounds of antimicrobials to kill it and the fourth round were IV drugs for an unrelated surgery. There are several different strains and some are harder to kill than others. I've heard horror stories of people who had to import medicine from other countries to get relief. Giardia isn't a bacterium, so not all antibiotics will work on it if that's what you have. Don't let your doc just push you off on a placebo antibiotic, if that's what you have.
posted by arabelladragon at 3:38 PM on May 3, 2011

IANYD, but several things stand out from your description. One is that this has happened on and off before. Two, this attack is different. Three, someone else was sick, but I suspect that is likely not related. Four, you are having a sulfur smell at both ends (burps and diarrhea).

You're going to need the help of a good gastroenterologist for this one. That's the short answer.

Honestly, I doubt it is Giardia. You've researched it and knowing that, you should be able to tell if you've been exposed. You usually pick up Giardiasis from contaminated water supplies. The incubation period averages about a week or two after exposure (but can be a few days to three weeks). Any exposures to river water or poorly chlorinated pools about a week or two before you got sick?

For Giardia diagnosis, it's recommended you repeat three stool samples over the course of a week. However, detection ranges from 90 to 97% depending on the lab and the method they use. If you have a good story for Giardia exposure, many docs will just go ahead and treat you, rather than bother with testing. Giardia is not invasive, so it shouldn't cause an elevated white cell count, or eosinophilia or a fever. arabelladragon, I really don't know what you had, but it may not have been Giardia. In the US, Giardia is not usually resistant to antibiotics and responds well to treatment with Flagyl (cheap), or Tinidazole (expensive).

What strikes me is that this has happened before. You could possibly have Giardia now, but there's no such thing as chronic intermittent Giardiasis, so that doesn't explain all the other times.

H. pylorii could certainly cause the sulfur burps, but shouldn't have anything to do with your diarrhea. You could have H. pylorii and something else....

Given you're having symptoms at both ends, I would suggest you also consider lactose intolerance. That, statistically, is the most likely cause of your on-again off-again symptoms. Another likely possibility is small intestine bacterial overgrowth. Less likely, consider celiac disease.

If I were you I would see your doctor and try the simple stuff first. If that doesn't work I would consider an upper and lower GI scope with a small bowel biopsy if possible. That should be enough to give you a diagnosis, or at the minimum, get many of these possibilities off the list.

Hope you feel better. Let us know how it all turns out. Best of luck.
posted by Meta-4 at 5:20 PM on May 3, 2011 [1 favorite]

Just wanted to add for the sake of completeness, it could have been a virus in the first place. You can get transient lactose intolerance or bacterial overgrowth after a viral infection. The key piece here is you don't STILL have a virus now, so something else is going on.

Ask your GP for a referral to a gastroenterologist.

Best of luck.
posted by Meta-4 at 5:25 PM on May 3, 2011

Swear to christ, I get that when I eat Cheerios. The explosiveness due to the milk and lactose intolerance, and the sulfur from the cheerios. I don't know what they put in there, but every time.

I also had a bout of something similar a few months ago, minus the sulfur. There was definitely an occasional "there is something wrong inside" perfume to the air, but it wasn't sulfurous. Ironically, it seemed to be encouraged and extended by the use of Prilosec.

Also, jumping off of this:

Honestly, I doubt it is Giardia. You've researched it and knowing that, you should be able to tell if you've been exposed. You usually pick up Giardiasis from contaminated water supplies. The incubation period averages about a week or two after exposure (but can be a few days to three weeks). Any exposures to river water or poorly chlorinated pools about a week or two before you got sick?

Do you have any Brita pitchers or water filters in the house?
posted by gjc at 5:37 PM on May 3, 2011

I had giardiasis for a long time without knowing. It was just like that.
posted by whalebreath at 5:39 PM on May 3, 2011

Another thought, and this has happened to me as well. I can't tolerate water supplies with chloramines in them. Couple times a year, my municipality seems to go overboard with them, and hilarity ensues.

(How to tell: when you fill the bathtub, is it greenish? Chloramines. If it is bluish, then it is straight chlorine and may not be the cause.)
posted by gjc at 5:41 PM on May 3, 2011

More details: I had giardiasis for 6 months without realizing it, because it is cyclical and I always thought it was gone, and because a doctor was hours away. I had to treat it a few times before finally getting rid of it, and the last time I was in the doctors office in tears and extreme distress that this was still going on. I'm fine now! There's hope!
posted by whalebreath at 5:43 PM on May 3, 2011

gjc, can you elaborate about the Brita pitcher point? Not to hijack the question, but I have been having my own set of GI issues lately, and we have a Brita pitcher in my house (and one of those water machines with the upside-down carboy of water at work). Is there something I should be looking out for with the water filters?
posted by wondercow at 8:31 PM on May 3, 2011 [1 favorite]

Don't get me wrong, I love me some delicious Brita water. But the mechanism is pretty simple: it's just a bucket of water on the counter. The "filter" is no more than a small container of sand (*) and if there were any badness in the water, any subsequent water would be exposed to the same badness.

(*) It is activated charcoal, I know. But for things the size of bacteria and cysts, it might as well be sand.
posted by gjc at 7:33 PM on May 5, 2011

Have you lived in the same place for all this time? Could it possibly be something in the water supply or a local food item? I had other suggestions but they're already listed above.
posted by chairface at 9:28 AM on May 7, 2011

For everyone having similar problems - my doctor agreed to treat me for Giardiasis, and that seems to have done the trick. Hope this helps someone else...
posted by Gianna at 6:51 PM on May 18, 2011 [1 favorite]

Also, thanks so much to everyone who took the time to answer. It really helped.
posted by Gianna at 6:51 PM on May 18, 2011

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