Thursday, February 10, 2011

Same Day Different Shit?

I just got back from my gastrointestinal doctor appointment. First let me back up a bit.

Back in August, I started having some mild abdominal pain, right around the time I also developed a sore throat (after Don had a cold or something for a week). I figured the bellyache was just part of the virus. The throat was better in a couple days, I never really got a full cold or flu, but the bellyaches continued, gaining intensity each day. About two weeks later, I went to the emergency room to check for anything serious.

Many weeks, doctor visits and tests later, I have learned:
1. that my gallbladder is only working about half as well as it should be (it's not contracting) though no obstructing stones were found, and
2. that I have gastritis "with erosions" that is not caused by the usual suspect H. Pylori bacterium.

As the weeks and months went on and the pain continued, I started looking into various theories about what could be going on in my body. I've pretty much gotten nowhere with that. All I knew was that I kept getting pain in my upper left abdomen, usually with episodes that liked to happen around 2:30pm for some reason, among other times of day and night.

More recently, I found a new GI doctor who prescribed a proton pump inhibitor (acid reducing drug) to see if it would help the pain by easing the gastritis. I was delighted to report that after three weeks on this drug, I felt super! I thought the ordeal was over with and celebrated a bit. (When you have Fibromyalgia, any bit of pain relief is an occasion worth celebrating!) I reported the success to my doctor via phone and he instructed me to continue the prescription for another month. If I continued to feel better, I could start weaning off it then. Alas, the bellyaches were only gone for about a week or two before they came back, but slightly different than before.

Oddly, I believe it was the day after I'd called my doctor that I started feeling abdominal pain again. This time, though, it was more in the general, lower abdominal area, and came with a widely varying array of "interesting" stools as well. I called the doctor again to let him know how I was feeling and he called in a new prescription for me to help stop my guts from having spasms, which is what he suspected was going on now. He further explained that, sometimes, when a patient has upper abdominal pain for a long time, even when it is relieved, the other abdominal areas can become more sensitive to pain. Since I'd been diagnosed with IBS in the past, he wanted to treat with a best guess strategy and see if it would help.

That same morning I discussed things with my doctor and he phoned in my prescription, I picked it up and started taking it before meals and before bedtime. By some odd coincidence, I also started having the wateriest stools I've had in years... every day, many times a day, and even waking up at night with this. Currently, I'm dealing with a constant abdominal pain at a level of 3 or higher most of the time, escalating up to about level 8 or 9 several times a day. I'm always in pain and I have lost my appetite a bit and started eating a lot less. (Plus, when you have painful, crampy, diarrhea for a long time, you quickly learn that if you don't eat, you poop less.)

So anyway, now back to today's visit. I saw my doctor and we discussed my progression of troubling symptoms. He says the proton pump inhibitor I'm taking for the gastritis can make some people susceptible to bacterial infection in the colon. Before jumping to antibiotics, however, we need to confirm that this is the case - with everyone's favorite lab testing method: the ever-popular stool sample. Oh boy. My nasty smelling "poison" poopy will be tested for four different kinds of infection, including the one that tends to occur with the drug I'm on. If it comes back negative, he will go with the next best approach, or possibly have me do imaging or other testing.

Guts problems are hard to diagnose. A lot of things can cause abdominal pain. Some of those causes are serious and others are fleeting. Many bacterial infections just run their course and die off after a time, too. It all depends on the test results.

While I wait for test results, I was instructed to take probiotics again (I'd stopped months ago, on the advice of a previous doctor before we knew of the gastritis), start taking some Pepto-Bismol for a couple days and see if that helps. If it doesn't, I was told to switch to Imodium.

I'll report news here once I know more.