Concerns About Potential Partial Small Bowel Obstruction
A 36-year-old woman, standing 5 feet 1 inch tall and weighing 105 pounds, is dealing with multiple health challenges including Mast Cell Activation Syndrome (MCAS), Postural Orthostatic Tachycardia Syndrome (POTS), hypermobile Ehlers-Danlos Syndrome (hEDS), along with various autoimmune conditions affecting her heart and digestive system, not to mention hormonal and pituitary issues. Recently, she experienced episodes of waking up after consuming heavy, carbohydrate-rich meals that led to lactic or metabolic acidosis. During these bouts, she faced severe spinning sensations, loss of equilibrium, extreme weakness, persistent vomiting, difficulty retaining fluids, and confusion. Previous instances of these symptoms allowed her to recuperate within a week following hydration treatment in the emergency room, during which her lactic acid levels registered at 3.4. This latest incident was triggered by indulging in a significant amount of freeze-dried fruit shortly before bedtime. Unfortunately, she has not managed to recover in nearly two months, continuing to feel nauseous, with the first week marked by an inability to eat or use the restroom. A subsequent visit to the ER resulted in hydration treatment once more, followed by her discharge. She now faces persistent constipation, being able only to pass very small, hard pellets, which is uncharacteristic for her. She oscillates between this constipation and occasional watery diarrhea, yet normal bowel functions remain elusive. Her appetite has diminished significantly; she survives on limited amounts of yogurt and a chicken patty each day. Thirst persists, sleep eludes her, and her dizziness and weakness continue alongside moderate abdominal discomfort. She feels profoundly fatigued, with muscle weakness and continual thirst disrupting her rest. There are times when she senses a cessation of breathing during sleep and experiences a significant slowdown in her heart rate, abruptly waking up gasping for breath and in a state of confusion. An abdominal MRI has been conducted as an outpatient procedure, and she is currently awaiting the results. The ongoing state of her health leaves her feeling extremely unwell, and the lack of improvement raises questions. In earlier occurrences, episodes of elevated lactic acid were followed by normal bowel movements, leading to an eventual recovery. The last notable food intake before the onset of this episode was a large quantity of freeze-dried strawberries and apples on the night prior to the onset of her symptoms. Thank you all for your support.
Answers (1)
3/17/2025, 4:36:30 AM
OpenHealth AI
Diagnosis:
It sounds like you're dealing with a complex set of symptoms that may involve a partial small bowel obstruction, particularly considering your history of autoimmune conditions and digestive issues. Your continuous nausea, persistent constipation, and episodes of severe dizziness and weakness are concerning, especially in the context of your Mast Cell Activation Syndrome (MCAS) and Ehlers-Danlos Syndrome (hEDS).
Evidence:
The symptoms you’ve described—waking with dizziness after meals, severe nausea, and constipation—can sometimes arise from food not moving properly through the intestines, which might indicate a partial obstruction. Additionally, your experience with lactic acidosis points towards possible metabolic issues linked to digestion. The fact that heavy, carbohydrate-rich meals are triggering your symptoms raises further concern about how your body is handling food due to your underlying conditions.
Action Plan:
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Monitor Symptoms: Keep a detailed diary of what you eat, your symptoms, and their severity. Note any trigger foods, especially high-carb items.
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Hydration: Since you mentioned recurrent dizziness and weakness, stay well-hydrated. Clear fluids like broths or electrolyte drinks can be beneficial. Coconut water is another low-cost natural option for electrolytes.
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Dietary Adjustments: Focus on easily digestible foods. Consider small, frequent meals rather than large ones to help your digestive system. Avoid heavy, processed foods and opt for simple carbohydrates, such as plain rice or bananas, if tolerated.
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Consultation: It's crucial to follow up with your healthcare provider, especially given your ongoing symptoms and the MRI results. This will help in determining if there is indeed a partial obstruction or another cause for your distress.
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Symptom Management: For the nausea and discomfort, ginger tea or peppermint tea may soothe your stomach. Small sips of these can be beneficial.
Cost-Effective Treatment:
- Telehealth Options: If you have access to telemedicine, consider a virtual consultation with a gastroenterologist. This can be a lower-cost option for getting specialized advice without traveling to in-person appointments.
- Community Health Clinics: Look for local community health services that offer sliding scale fees based on income. They can provide follow-up care and additional support.
Remember, it's essential to address your healthcare provider's recommendations based on the MRI results and other tests. The complexity of your health issues necessitates ongoing medical support.
If this answer is not sufficient, please consult a medical professional for further guidance.
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