IBS or Not ?

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Hello.

My name is Andrew, I am 34 years old and prior last summer I haven’t ever visited a doctor for any issues.

This post is a long shot and a cry for help since after a lot of visits to different doctors and quite a few diagnostic examinations, I still feel un-diagnosed and left to live with the question on what’s wrong with me.

I would like to apologize if sometimes my English read a bit awkward, but I am kind of rusty in typing a more demanding in a vocabulary story.

Some basic info

Age: 34, Male, Nationality Greek – (Mediterranean)

Current Weight – 63/64kg – Height: 1.72

Known Medical issues: Mild Scheuermann’s kyphoscoliosis / Thalassemia b trait

Some history:

As I said I have never visited a doctor and I had no known issues other than the above medical issues which 1) I have from puberty (kyphoscoliosis) and 2) Thalassemia (from birth).

*note 1, I fixed before the main episode (described below) quite a few tooth’s I neglected and had starting forming cavities. -> I also pulled out an old tooth root canal that was beyond saving.

*note 2, I was treated with Axetine 500mg Cefuroxime on June for 10 days/ 2pills per day for a bacterial throat infection

The main problem

Last July while at work I had an episode that would be best described as a panic attack or a pre syncope episode, I was working on my pc when I started feeling disoriented, a bit blurry looking at the screen and with a shortness of breath. I went to the bathroom to throw some water on my face and shake it off as I thought it might be dehydration and/or overworking the past few days. I urinated also since I was feeling bloated and that’s when I felt a cold sweat and a sudden tachycardia (in the range of 140-160 bpm as more episodes followed and I recorded the next days), I notified my colleagues and since they were alarmed seeing my ghostly white skin color, they decided to call for help. After 15 minutes or so lying down I got a bit better and the paramedics came, they took my blood pressure, oxygen levels and said I seemed fine but to be sure I should visit the hospital to get checked out. Sine I thought it was a onetime thing and everything might be a result of exhaustion I went home to get some rest and see how I would feel the following day.

Well, the next day was normal up until early evening where after a good lunch and while in a rested position I experienced again a tachycardia episode, I tried to stay calm and measured my bpm in 15sec x 4, resulting in a 152bpm tachycardia all of a sudden without any increased levels of anxiety or any other physical/psychological stimulation.

The next day I visited the emergency on a private hospital asking for an explanation and I started with diagnostic exams that continue up until recently, since more episodes followed and still I am experiencing symptoms.

Basic symptoms

Severe bloating – is the most persistent symptom, especially after the first meal of the day, bloating continues all day and I feel better only early in the morning after I wake up or after I visit the toilet and have a successful bowel movement. This symptom is following me every day without an exception from the first episode.

Tachycardia episodes as described above, they start with a shortness of breath usually after being bloated all day, they last a few seconds 30 or so and after a 15-20 minutes period I recover. (I haven’t got one in the last 40 days or so but I had overall maybe 15 episodes from July 2018)

Occasional heart palpitations - or being more aware of my heartbeat by feeling its rhythm in the chest, neck, throat etc.

Loud abdominal sounds, coming from the stomach and/or bowels

Occasional constipation - Abdominal pain and trapped gas – pain comes and goes but it seems most of the pain sessions come when I am constipated or unable to pass gas.

Low body temperature, I remember my regular temperature was 36.6c / 97.88f from readings when u get better after a flu etc, nowadays I get 35.4c/ 95.72f υp to a 36.1c/ 96.98f maximum

Significant Hair Loss (more than 20 hairs on simple pull test) – could be irrelevant or stress related due to the situation I am experiencing but I think it is worth mentioning since I actually wondered in the past how is it possible to have such strong hair and I never noticed hair falling out.

Some lifestyle history

I am a smoker for the most of my adulthood, usually 10 to 15 smokes a day

I was a heavy drinker, I would never drink during the day but when I got off work I usually would have 2 to 4 drinks on a regular day (depending on how tired I was) and might get up to 8 or more drinks on special holidays or events (once or rarely twice per month)

I usually take up demanding roles in my career (Store manager in flagship retail stores, now e-commerce manager etc) that cause stress but (in my opinion) I manage and use that stress creatively to enhance my performance.

I did little to no exercise since I enjoyed (from what I could tell) a high metabolism, always stayed thin even after consuming high calorie meals mostly at night.

I won’t lie I treated my stomach really bad, I have never had a regular eating schedule for many years and for large periods of my life I would only have a large meal (usually in the evening ). I avoided eating during the whole day and at work since I felt eating was getting me sleepy or less active than on an empty stomach.

I consumed large meals and high calories alcoholic drinks at the evening – night and that’s probably how I maintained my weight.

The weird thing is I never had stomach issues with the above lifestyle no more than a rare indigestion when my meals were high in saturated fats/ fried etc.

During my treatment on the bacterial infection I had to eat more regularly for the antibiotic rounds so I decided It was about time to change my eating habits for good, as I did the following period. that’s when I started to feel bloated for the first time but I attribute it in the change of my eating habits, the more meals that I consumed and starting to put on weight.

During the past months I also cut back on alcohol to maybe 1 drink or no drinks during working days and maybe have a couple of drinks on weekends.

After going down to 57kg on weight when the symptoms were more severe last summer I tried and kept a better diet of 3-4 meals & snacks and now I am back to 63/64kg.

I have cut down on caffeine intake too, usually only one coffee at the morning, and sometimes a second one after midday.

I have started working out 5 days a week mainly weights and some cardio.

My diagnosis atm is Severe IBS, but honestly I don’t know what to believe since I haven’t had a clear day of symptoms, not one… and every day I feel from crap to desperate and I got sick of complaining to myself or others (who won’t possibly understand and most of them suggest relax and attribute my symptoms to anxiety or stress) – I was also found positive with H.pylori and I was treated.

I have done the following diagnostic examinations all of them came back in normal – or slightly off normal ranges as my doctors say.

Abdominal ultrasound, Gastroscopy, Colonoscopy, MRI enterography, Heart ECG, cardiac echocardiogram)

Bloodwork:

3xdifferent full blood counts

Calprotectin ❤️0μg/g negative

Helicobacter pylori blood antibodies igG

Electrophoresis (confirmation on Thalassaemia Trait Beta)

Urea

Uric Aciid

Creatinine

eGFR (MDRD)

SGPT (ALT)

SGOT (AST)

Serum Iron (FE) (3 different analysis twice at first symptoms and one recently)

UIBC

Troponin-T

CRP

Glucose Fasting

Cholesterol Total, HDL Cholesterol, Triglycerides, LDL Cholesterol,

HbA1c IFCC, HbA1c DCCT

Calcium

Magnesium

Albumin

Ferritin

TSH-FT3-FT4 (2 different analysis one at first symptoms and one recently)

Cortisol (am)

B12 Vitamin

Folic Acid (2 different analysis one at first symptoms and one recently)

h.pylori Ag feces – negative for treatment h.pylori confirmation.

Docs subscribed and I tried the bellow medications (the ones for IBS that doesn’t seem to work).

Controloc 40mg pantoprazole

Nexium Esomeprazole for mild Erosive oesophagitis, Gastritis, duodenitis findings in gastroscopy

Nexium + Amoxil + Claripen for positive Clotest biopsy of H.pylori

Duspatalin Retard (mebeverine hydrochloride 200mg)

Librax (Clordiazepoxide + Bromure de clidinum)

Tempocol Pepermint oil capsules

Deanxit Flupentixol 0.5mg – melitracen 10mg (currently using)

axentine cefuroxime 500mg for Bacterial throat infection before the actual story

a tetanus shot & Augmentin + Cal.pootassium 625mg for a dog bite I got after a neighbors overexcited and over friendly dog.

I have also tried some over the counter medicines or supplements after consulting doctors but did not help

Ortis Fruit&Fibres, Dulcosoft (macrogol) for constipation relief

Dulcogas (simethicone) for bloating

Lumaren Ranitidine 150mg for bloating / stomach neurosis

Maalox Plus for indigestions

Nopar (Spasmolytic anticholinergic, 4mg Homatropine methylbrmide)

Buscopan plus for abdominal pain / bowel spasms

Folic Acid supplements, b12 supplements, Chios Mastic gum supplements

My current doctor says I should stop doing any more exams and focus on controlling what seems to be a persistent IBS, but honestly I am not convinced and deep down I feel there is some other underlying condition that I could treat either with more lifestyle changes or medication.

What could be missing? Any other possible conditions I should bring to the attention of my doctor or any other diagnostic tests I could take?

I could post all findings from the examinations if that’s helpful…

Thanks for reading this!

Andrew.

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  • Posted

    Hi there

    Your varying range of symptoms are most likely all stress related, most stress issues affect the gut!!! Remember that IBS is really the gut becoming inflamed and stress is one of the key promoters.

    I would personally keep a food diary and see what if anything makes your symptoms worse, cut down on smoking, coffee, alcohol and eat very lean and clean. Do also try to relax, take up something like yoga that reduces your cortisol output - mindfulness is key!!

    very best wishes.

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    • Posted

      i try to implement all above, have slowed down in alcohol and caffeine intake and still trying to cut down on smoking.

      eating habits changed a lot but still adjusting to be honest.

      stress is different nowadays, i find my self more stressed on how to manage my "IBS diagnosis" if that's actually it and i find my self in a loop of anxiety cause by the symptoms. i take it slower / easier at work and all i have achieved by now is physiologically managing the symptoms better but not alleviating them.

      The workout i am doing seems to help a bit but i still have a long way to go on starting feeling fit again.

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  • Posted

    Since you have already done everything and nothing seems to help you can try looking into a rehab facility where they can administer to you round the clock. You can always leave if you don't feel you are being helped. While there is no known cure for IBS and other problems, you can learn how to manage with it comfortably.

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  • Posted

    Listen to your doctor and focus on controlling your diagnosed IBS with diet, antispasmodics/painkillers and managing your stress levels. With IBS, nothing will show on scans and you have had plenty of them. You already have your diagnosis. Try to relax and try concentrating on the things you enjoy and you will find when you are focused on something else, your IBS will subside. This strategy works for my IBS. When I was stressing about not having a diagnosis, my IBS was constant for three and a half months and I had daily pain in varying degrees. Once I was diagnosed, my health anxiety disappeared and my IBS changed to come and go symptoms with long remissions. My symptoms only come back when I am stressed.

    Stress can cause IBS and can trigger IBS flare ups.

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    • Posted

      I am trying to manage stress, but the symptoms wont let me take my mind of it, still doing lifestyle changes i hope they help but if they do they do it very slowly, it was about time i changed some stuff anyway so only good things can come by doing so, i do think though i need to try a full low FODMAP diet for a month just to check if that would help or not.

      i am glad you managed to have long remissions, i hope i do too soon enough.

      thanks!

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    • Posted

      The gut and the brain are strongly linked. That is why distraction techniques do work. If you are thinking and doing pleasurable things, this in turn will relax your stomach. If you are feeling anxious, this will be reflected in your stomach by means of pain signals. Try persevering with distraction techniques and tell yourself that they will work and you will find your symptoms will improve. Your symptoms will let you take your mind off it if you let your mind relax.

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  • Posted

    i was diagnosed with IBS AND NEVER BELIEVED I HAD IT....tried many things. FINALLY i tried cholestryamine. it is a powder you drink. it comes in small packets by prescription. i took one a day.....drank plenty if water. Took one box of it and took a Flora 50 billion probiotic, urgent care. in 2 weeks it was gone. no pain, no bloating, no runny stools, nothing. apparently it is used for gallbladder pain or for those who actually had their gallbladder removed, which had 2/years before. my doctor said it would not help but agreed to give me the subscription. That was a year and a half ago. I also had the same heart problem and ended up taking a beta blocker for two years. I t also stopped about 2 years ago but is back....i started the same pills again, while waiting to see the hear specialist and the heart racing and palpitations have stopped. the hair loss i believe is definitely stress. All your tests showed nothing, so just maybe try the probiotics, FLORA, is the best one and the cholestryamine. you have nothing to lose. really sorry for all of your frustrations.

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    • Posted

      i forgot to mention it on the initial post but i took 3 different probiotics and didn't see much difference, one was ultrabiotic plus and second one was iMUTIS, cant remember the third one, i will check flora if its available here, ill also check with cholestyamine and ask my doc.

      thanks! hope you doing better by now

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  • Posted

    hi andrew,

    Sorry to hear you have been having a hard time. Some of your abdominal symptoms are similar to my own, i have bloating that gets worse throughout the day, regardless of what i eat, stomach pains and a lot of weight loss. i was very fit and well before i became ill 6 months ago, food diet, no smokong or alcohol so it has been a huge shock to become so unwell for me. i have had almost all of the tests you mention too and nothing has been found. i was diagnosed with exocrine pancreas insufficiency based on a faecal elastase test which measures the amount of digestive enzymes the pancreas is producing - but after a clear MRCP scan this has been retested and consultant advised the original diagnosis was wrong, presumable to a test error and i dont have it after all. i have mentioned this though as you said you drink alcohol fairly regularly and this is an illness that normally affects people who drink.

    the main thing that stands out in your post is the comment about your cavaties and root canal removal just before you got ill. i became ill within a few weeks of having my wisdom teeth removed. i have recently had a cavitat scan which shows i now have cavitations beneath where the teeth were removed. cavitations have been known to cause serious illness in some (not all) people, and i am having a surgery to have mine removed and the sockets cleaned properly. they commonly occur after teeth extractions or root canal treatment. what work did you have on your teeth? you mentioned cavaties- did you have the cavitations removed? or just fillings/root canal?

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    • Posted

      ummm... i dont think i was checked for exocrine pancreas, ill ask though if any analysis i made could indicate i was supposed to. I read abit about it and it could match some of the symptoms if enzymes (lack of) are causing the stomach bowels issue and indigestion.

      as for my teeth i did some fillings on decayed tooths i neglected, dentist told me we saved them all apart from an old root canal tooth i had to remove, ill schedule a routine visit to get them cleaned soon and ill ask if they (the work we did) could possibly cause such a reaction on my gastrointestinal system.

      let me know how it goes with your surgery and if that helped you by any way.

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  • Posted

    Hi Pitskid

    I noticed looking at all your tests you were not tested for thyroid problems. Thyroid problems can cause hair loss or thinning or weak hair plus stomach problens and weight loss/weight gain depending on hypo or hyper thyroidism. Also, you mention you take vitamin supplements do you take vit d regularly which if levels are low will cause gastro and stomach problems. Coming from a hot climate i guess you get plenty of sun if you still live in Greece/Cyprus....

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    • Posted

      Hello Mary,

      I actually was checked for TSH-FT3-FT4 twice, there are specialized tests as they told me in the lab for thryroid problems but if TSH - FT3 - FT4 are actually on normal ranges (they said) its a long shot doing the more expensive and "advanced" thryroid tests and find something going wrong. you think it would worth the shot? ill ask my doctor.

      Honestly i am not usually taking vitamin supplements, i started doing so after problems started last summer, on my initial blood analysis although all vitamin checks were ok, my doctor prescribed B12 and Folic acid because they where on the lower side of "ok range / scale" all other vitamins i tried my self ex. for hair loss and stomach issues to see if they could help in any way. (they didn't)

      i currently live in Cyprus so i would not say its a vitamin D deficiency, i do get enough sun exposure i think.

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    • Posted

      The standard thyroid tests are not always accurate; my mum had this problem. Ask for the more advanced tests. If your thyroid is the problem, it is better to get it treated as soon as possible.

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    • Posted

      Hi Pitskid

      Yes, do go for further thyroid tests. Also, do keep up with the B12 and folic acid as low levels of these can also cause gut problems. You do have to take multivits for a good length of time to see a difference.....

      Report Reply

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