Stomach issues……could it be be IBS or what?
August 29, 2022 9:27 AM   Subscribe

My son’s has been having stomach issues for few months now.We saw a gastroenterologist.He did some blood work and didn’t diagnose anything but suggested elimination diet to find the trigger foods that causes pain.

We realized that my son was getting upset stomach whenever he ate onion & garlic.so,we eliminated those.he has been doing very well for the past 1-2 months without any pain at all.He is on gluten-free,dairy free and soy free diet .He has been taking supplements including zinc,probiotics. He eats good fiber, protein rich foods (lentils,quinoa,oats,brown rice).He likes all fruits and veggies.No constipation at all.But has bowel movement after every meal including snacks(Is this normal?……………..). . It’s like he is hungry all the time and needs to eat every 1-2 hours. When we mentioned this to the doctor, he said his weight is normal for his age ( he’s in his 20’s) and probably need more carbs.The doctor did some blood work for H-pylori,IgE, IgG and said everything looks okay.So, doctor had nothing more to say or diagnose but asked us to watch out for triggers.

Last few days he has been suffering from pain every time he eats.But he calms down after 30-40minutes of eating and the same cycle starts after every meal.He use to drink coffee,chocolate milk and spindrift(no sugar) but we stopped after the stomach issues started. He only drinks almond milk/ peppermint tea/chamomile tea and turmeric ginger tea.

Yesterday night,he woke up in the middle of night crying in pain. I gave him Tylenol .It didn’t help immediately but then after sometime tried peppermint tea.He calmed down and slept.I’m not sure if Tylenol or peppermint helped but it worked.

We’ve been doing our research and feel it could be IBS……. I looked at the FODmap and many high FODmap foods he has been eating all along without any problems.As such he has been on restrictive diet because of his allergies and somehow we have found healthy, balanced and tasty foods.I don’t know how much to restrict anymore….it’s so frustrating!!!

Does it sound like IBS? We are trying to learn as much as possible before we take him to the doctor again to get a diagnosis.

We’re not sure whether to go to the same gastroenterologist or find a different doctor and get a second opinion.I’m so confused………..

My questions are:

1)How do you get a diagnosis?What exact symptoms should I look out for?

2)How do you get treated other than just avoiding the triggers?

3)How do you manage when you’re in pain? Is there any home remedies that could help immediately when he is in pain?

4)Are there any medication(OTC/prescription )that helps with the pain?

5)Mefites,whoever has gone through this,could you please explain how you felt when you were in pain?

Reg question 5: My son has ASD and his tolerance level to pain is very very low.He doesn’t exactly explain what’s happening in his body unless it’s a mild aches and pain.He has speech delay.He can communicate with us or with anyone most of the time with minimum information but it’s gets harder for him when it comes to explaining things in details especially when he is in pain.(This is the reason why it’s difficult when doctor is asking him for symptoms).

I want to understand where it hurts or how it feels when you are in pain having IBS.This will help me to navigate my communications with him to find relief.He has been suffering with food allergies since 3years old .He knows exactly his allergy foods that triggers his itching/hives and has avoided in school/college too. I always explained to him in detail whenever he had a reaction to particular food.That’s why I never had to worry about him eating any allergic food when he is alone .But this IBS (?) is a new problem that I don’t know anything about to explain to him.

So,I’m back here hoping for suggestions to help my son…………..
posted by SunPower to Health & Fitness (20 answers total) 1 user marked this as a favorite
 
Even if it's not supposed to be, IBS is generally treated as a diagnosis of exclusion.

I'm surprised the GI didn't suggest a colonoscopy--with the symptoms your son is having, I would strongly suggest one as it's important to rule out some form of inflammatory bowel disease.
posted by rhymedirective at 9:54 AM on August 29, 2022 [3 favorites]


I have IBS.

Concerning fodmaps, it’s a huge list and not everything will affect him equally. There are some that I avoid like the plague. Some that are entirely harmless to me. So there is a whole lot of trial and error.

I would call the doctors office and tell them what is going on. But it might be best to find another doctor. I’ve had quite a few gastroenterologists that seemed really dismissive. To be fair, a major part of the treatment really is to avoid triggers. So, again, there is a whole lot of trial and error involved. But regardless, they should be more concerned.

Drinking something acidic like sparkling water or acidic tea (ginger lemon, rosehip hibiscus, etc) kinda helps me after meals. But if I eat one of my triggers, I’ll get the same cramps after eating that your sons seems to be experiencing. Actually I get cramps for days if I eat certain foods.
Pain/cramps right in the stomach area, below the rib cage. Usually after I ate.

L-glutamine supplements help if there are injuries to the guts. Can’t hurt.

Oh, I’ve also had pain lower down where the intestines were, and that was due to colitis. Very painful! But it wasn’t just after I ate.
posted by Neekee at 9:58 AM on August 29, 2022 [1 favorite]


One suggestion, at least in the short term, would be to stop the turmeric ginger tea. Turmeric can cause stomach upset. Maybe switch to just plain ginger tea, or lemon ginger tea.
posted by gudrun at 10:13 AM on August 29, 2022 [1 favorite]


My cramping and runs were severe enough that I was missing work and losing a fair bit of weight. I couldn't eat and, in the morning, was in between running to the bathroom and lying down in pain. One of the two-week bouts of this required a visit to the ER, as I was pretty dehydrated. CT scans and a colonoscopy were negative.

GI specialist couldn't/wouldn't do anything for the severe pain I was in, and so he diagnosed IBS and sent me to a psychiatrist. I was put on a low dose of nortriptyline, which helped slow down and quiet the part of the nervous system in and around my gut. I don't take it any longer; now I take probiotics a few times a week and my insides are feeling mostly alright these days.

IBS is no joke, and I hope your son feels better soon.
posted by They sucked his brains out! at 10:16 AM on August 29, 2022 [1 favorite]


Are you sure he's getting enough protein? Rice and oats aren't high protein foods.
posted by kingdead at 10:22 AM on August 29, 2022


I don't know much about IBS - as far as I know I don't have it. But you had asked if eating all the time and pooping a lot is normal, and well, it is, for me. Sorry for the TMI, but yeah, I absolutely poop after each meal, often multiple poops. I probably go 5-6 times a day. I'm also hungry all the time, and I was especially so in my 20s. If I had the time and could have afforded it, I absolutely would have eaten every two hours, full meals. Even now, I take my lunch break at 11:30, and even that's only because takeout places don't usually open for lunch until 11am. I eat breakfast around 9am, for reference. "Second lunch" has become kind of a running joke in my office, but with Doordash it has totally become a thing. And I'm 42 now, and still eating this much. I'm probably statistically not "normal", but I do want to reassure you that merely eating and pooping a lot at least happens to other people. What's different is the pain. I don't usually feel any pain after eating. That makes me think that there's something more going on. Best wishes.
posted by kevinbelt at 10:49 AM on August 29, 2022 [1 favorite]


I gave myself wicked GI distress taking zinc when I was worried about flu outbreaks in the precovid times at care facilities. Try stopping that and the turmeric. No one needs turmeric and it increases bleeding risks.
posted by cobaltnine at 10:50 AM on August 29, 2022 [4 favorites]


Good point about the protein. Is he vegan (by choice or necessity?) If not, adding white-meat turkey (or chicken) is often well tolerated and a good protein source and should not be a FODmap issue either, and might help with the hunger/satiety issues.
posted by gudrun at 11:16 AM on August 29, 2022


Response by poster: Thanks Neekee for the l-glutamine suggestion.Just saw this article Glutamine Supplementation Enhances the Effects of a Low FODMAP Diet in Irritable Bowel Syndrome Management which is very promising.
posted by SunPower at 11:18 AM on August 29, 2022 [1 favorite]


I have IBS and it flares up occasionally (hello, last week, you sucked) and does weird things like what your son is experiencing. These flares seem to last about 4 days and nothing much helps, unfortunately. I would recommend trying ibuprofen instead of tylenol if you can, though, because my understanding is that it is more of an anti-inflammatory than tylenol. It does seem to help me a little bit.

The other, somewhat counterintuitive, thing you may want to try is less fiber. I am gathering from your list of food that your family are vegetarian. I am as well and I notice that when I eat too much fiber I pay for it dearly. During flares like last week I can really only eat rice - white, not brown - tofu, miso, eggs and a few judiciously added vegetables. Saltine crackers are also ok - think the old BRAT diet: bananas, rice, applesauce and toast. Brown rice, oats and most fruits are too high in fiber for me to tolerate during flares.

When you are on a vegetarian diet it's normal to be hungry more frequently, particularly I think for young men in their teens or twenties. When my son was that age he could have happily eaten a full meal every two hours around the clock. Adding meat back into the diet does help a little with that. I've noticed that I occasionally have meat cravings just as a flare starts. I don't usually do anything about it and on the rare occasions that I do cave and eat some chicken or something I don't notice much of a difference, still, you could try it.

To answer your questions specifically:
1) I got a diagnosis via an offhand comment from my gynecologist. That was years ago and every doctor I've seen since agrees with her. There isn't a conclusive test: if you have all the symptoms, then you have it.

2) My experience has been that you don't really get treated. There isn't much anyone can do. You just put up with it. I have found that it lessens for a while then flares up a lot, then lessens again. Stress and lack of sleep can make it worse as can lack of exercise.

3 & 4) There's not a lot that helps with the pain. Ibuprofen and moving around or, sleep. You may want to try Gas-X (simethicone) it can help. Sometimes I will take Pepcid A/C and gas X and together they can help for a while. Be careful not to overdo it though because I find the Pepcid can lead to worsened constipation and that is extremely unfun. There's an herbal tea called stomach-ease that's a combination of ginger and peppermint that has also helped me somewhat. Exercise helps a lot. Yoga - child's pose is good. I'll stay on the bathroom floor in child's pose for quite a while sometimes. And sometimes, a bowel movement will make it better - but not always!

5) At it's worst, I refer to the pain as shredding. It feels as if Shredder from the ninja turtles is in my abdomen and trying to work his way out. Yeah, it's great. That's the really bad acute double over stuff though and thank the gods, that doesn't usually last too long. Sometimes it's an endless dull ache. Usually it's in my lower abdomen (hence all the gyno consults of my youth) although it can move around and be all the way up into heartburn. Sometimes, but not always, my stomach is really swollen and hard.

Hope this is helpful! It's a fairly miserable thing but at least it is not constant. Good luck!
posted by mygothlaundry at 11:25 AM on August 29, 2022 [2 favorites]


(Warning, gross)

My ibs is consistently triggered by chocolate and almost always triggered by tomato sauce. It feels like a backache combined with a swollen balloon in my gut, and I used to be worried about it popping. Forcing myself to vomit up everything in my stomach helps immensely and immediately. That brings the pain down to a 2-3, dicyclomine (bentyl) and ginger help after that.

When I questioned if this was really ibs, a nurse told me unofficially that if dicyclomine helps it, it’s ibs. But there’s no formal diagnostic test, I think.
posted by Vatnesine at 11:59 AM on August 29, 2022 [2 favorites]


I have diverticulitis and present with similar symptoms when I eat too much fiber. The lentils, rice, quinoa, fruits, veggies etc. may be making things worse.

I get really sick if I eat quinoa or brown rice and forget about black beans.
posted by yes I said yes I will Yes at 12:57 PM on August 29, 2022 [1 favorite]


And just to make my point about there not being much treatment, I was diagnosed with IBS over 20 years ago and I was today years old when I learned that there is a prescription painkiller for it. Now granted I am a woman with anxiety and depression, which clearly makes me a completely unfit patient who is no doubt making everything up, especially now that I'm postmenopausal, but still, wow. Just wow. It's a good reminder to keep on doing your own research. I'll be looking into dicyclomine right away, so, thank you Vatnesine!
posted by mygothlaundry at 1:27 PM on August 29, 2022 [4 favorites]


Is there the remotest possibility that this might be appendicitis? I know you said it's been several months, but a friend's son (age 15) had similar pain to what you have described, also for several months. The pediatrician leaned hard on diet and they tried an elimination diet. Nothing yielded durable relief. My friend kept returning with her son to the office and the doc kept having the kid hop up and down on one foot in the office. (This is a long-time short cut to pinpointing pediatric appendicitis). The doc kept saying it wasn't appendicitis and it HAD to be a diet intolerance. The kid apparently wasn't exhibiting the "right" symptoms for an appendicitis diagnosis, till a few weeks later when he spiked a huge fever, had an excruciatingly painful and tense abdomen, and after a midnight rush to an ER was discovered to have a necrotic and ruptured appendix. He was at that point too sick to operate on, and was hospitalized more than a week for IV antibiotics and pain control. The antibiotics did clear up the infection and he's fine now. Fortunately.

Has he had any abdominal imaging? That would at least rule out something like appendicitis, and might shed some light on other possible sources of his abdominal pain. Good luck to him and your family.
posted by citygirl at 3:20 PM on August 29, 2022 [1 favorite]


Having suffered from a variety of gastrointestinal ailments over the years, I think it is definitely time to go back to the doctor. Maybe a different doctor. Agreed that you should stop the zinc and the turmeric supplements. Ask the doctor for a stool test to screen for parasites and about getting screened for appendicitis. If they want to do a colonoscopy/endoscopy, do it! It could also be something like SIBO, but all of this requires more investigation by medical professionals. And it may take multiple trips. Guts are complicated. Good luck!
posted by purple_bird at 4:20 PM on August 29, 2022 [1 favorite]


Response by poster: Thank you for the suggestions and sharing your experiences dealing with IBS.

First going to find a new gastroenterologist.That was my first instinct too.Will be preparing my questions and try to get CT scan/colonoscopy/endoscopy/any tests done if needed to find the problem.I can’t see him suffer.

I always thought taking zinc prevents cold/flu and I need to revisit its effects on guts.

Dicyclomine for IBS…will be looking into that for sure…thanks Vatnesine.

Looks like the pain you described going through IBS is terrible and I can understand now how my son must be feeling…..I have lot of work to do….…thanks everyone.
posted by SunPower at 6:00 AM on August 30, 2022


Regarding zinc, I came across some info about this while researching MCAS. Here is an explainer (sorry about the weird formatting, but it was one of the more straightforward articles I could find.) Hope he finds relief soon!
posted by Rube R. Nekker at 8:34 AM on August 30, 2022


Response by poster: Fortunately got to see a new gastroenterologist yesterday and he wanted to do all the tests one by one to diagnose the problem.
He asked us to stop the zinc (thank you all for the warning).
He asked us to start giving him Prilosec from today.
He did blood work yesterday itself and ordered a CT scan to be done outside.
The blood results came already with many red flags…like

Red blood cell count…6.4 (High)
Hematocrit……………….52.0(High)
Protein……………………..8.9(High)
Calcium…………………..10.5(High)
Albumin……………………5.4(High)
Alkaline phosphates….148(High)
ALT………………………87(High)
AST……………………..44(High)

Red blood cells and hematocrit being high are very concerning. I am trying to stay calm which is very hard though….

Everything was normal 3 months back when we did the blood work in June..so something is not right for sure…

Before I talk to the doctor,just want to know from all of you about these red flags…..what the numbers means, what to expect and what questions to ask the doctor.

Thank again
posted by SunPower at 6:59 AM on September 8, 2022


I put those lab results and the symptoms you listed into Isabel symptom checker. It will spit out different answers based on which symptoms you list, so you can play around with it. They explain that these are supposed to be starting point suggestions for further consideration. Like a brainstorm. It came up with the following:

COMMON

Alcohol Toxicity
Viral Hepatitis
Pancreatitis
Heart Failure

RARE

Liver Cancer
Cholangitis


As a non-expert I would be calling the advise nurse and asking if I should be concerned about pancreatitis.
posted by aniola at 10:54 AM on September 8, 2022


I am trying to stay calm which is very hard though….

Your adult kid is young and pretty healthy and has you looking out for him.
posted by aniola at 11:59 AM on September 8, 2022


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