Endoscopy Aftermath: Struggling with Stomach Issues, POTS, and Chronic Fatigue—8 Months of Uncertainty
Age 31, male. I have been dealing with mild gastritis for nearly a decade, a condition that was confirmed through biopsy. Given the history of cancer in my family—my father passed away at 47—I have taken my gastrointestinal health extremely seriously. Recently, on July 4th, I sought out a gastroenterology appointment, where they performed an endoscopy along with a biopsy. This was my first biopsy despite having undergone several previous endoscopies. The findings revealed gastritis characterized by intestinal metaplasia, bile reflux, and erosion in the duodenum. My dietary habits have always been quite healthy. What followed the procedure was a dramatic shift in my well-being. Almost immediately, I began experiencing discomfort in my stomach and abdomen. Within a few days, I was hit with severe cramping that lingered for weeks. It wasn't long before my digestive system seemed to completely shut down; I endured relentless pain, particularly in the upper stomach area, accompanied by nausea and a complete absence of appetite. This level of distress was unprecedented for me. The contrast of my condition pre- and post-procedure was stark; I suffered substantial energy loss, an aversion to food, and began experiencing heart palpitations. The most challenging phase occurred from July through early September. Following this period, a cardiologist diagnosed me with POTS after conducting tilt-table tests at intervals of three and six months. While I've noticed some improvements, my POTS symptoms persist along with ongoing nausea and intense stomach discomfort, especially in the upper abdominal region. The severity of the pain has made even walking a challenge. It is a unique type of pain compared to what I experienced prior to the endoscopy. I was generally in good health before this incident. Attempts to manage my condition with anxiolytics have proven ineffective. Some healthcare providers attributed my symptoms to anxiety or depressive disorders, claims I found perplexing since I had never faced such issues. I am currently in the process of tapering off Mirtazapine, which I was prescribed even though I lacked any prior indication of anxiety or depression; lowering the dosage has intensified my nausea. I regret ever starting this medication. **There have been no indications of H. pylori infection** through blood work, stool tests, or biopsies, prompting me to consider a breath test or re-evaluating other assessments for thoroughness. **I feel utterly drained, as if my body has entered a state of shutdown.** Despite undergoing numerous private tests that largely returned normal results, one notable anomaly has emerged: **extremely high ASCA IgA (187, reference range 7-10) and elevated ASCA IgG (24, reference range 7-10).** Additionally: * **Fecal calprotectin and lactoferrin results are normal.** * **No occult blood detected in stool.** * **Crohn’s disease seems improbable, but could it still be a possibility?** My physician suspects that **POTS may arise from an underlying condition.** Given that my symptoms escalated following the severe abdominal cramps that followed the biopsy, I am starting to consider whether a bacterial infection or other factors have induced systemic complications leading to my POTS diagnosis. Furthermore, I have researched **MCAS (mast cell activation syndrome)** and its potential connections to invasive procedures like endoscopies. Since October, I have also been dealing with persistent **pain in my neck and head**. Recent analyses indicated **deficiencies in copper and ceruloplasmin,** which I am addressing through a tailored regimen of vitamins and supplements. A **CT scan of my abdomen and chest yielded normal results,** and I am scheduled for a **colonoscopy and an additional endoscopy with biopsies at the end of April.** # Key Symptoms Impacting My Daily Life: * **Intense abdominal pain** (particularly in the upper region, severely hindering mobility and physical activity) * **Nausea** * **POTS symptoms (experience of tachycardia upon standing, overwhelming fatigue, dizziness)** * **Chronic neck and head discomfort** * **General weakness and inability to maintain employment for the past eight months** * **Some improvement in appetite (though still diminished, which marks progress)** # Additional Test Findings: * **Positive ANA 1:100 (++); all other autoimmune markers (C3, C4, anti-dsDNA, ENA) returned negative** * **DFS70 result was strongly positive** * **Normal CRP and ESR levels** * **Celiac disease ruled out** * **Blastocystis spp found in stool samples, but is not deemed significant by medical professionals** I am truly perplexed by my condition, unable to work for the last eight months, experiencing weight loss, and feeling fatigued. This entire situation has also led to considerable stress. It is difficult to comprehend what is happening with my health. If anyone has suggestions on further tests to pursue or methods I might employ to aid my recovery, I would be extremely grateful for your input. I have invested thousands on vitamins, consultations, and various treatments without resolution. **Thank you for your assistance!**
Answers (1)
3/19/2025, 5:31:09 PM
OpenHealth AI
It sounds like you've been through a very challenging time with your health, and your detailed description highlights a number of serious symptoms and concerns. Your experience post-endoscopy, particularly with the development of intense abdominal pain, POTS, and chronic fatigue, is understandably distressing. Let’s break down what’s happening and outline some potential next steps for you.
Main Points:
- Complex Health Issues: You are experiencing a combination of gastrointestinal symptoms, POTS, and fatigue, which may be interconnected.
- Need for Comprehensive Management: Given your unique medical background and recent developments, a comprehensive approach to assess and manage your symptoms is crucial.
Explanation:
You have chronic gastritis, and post-procedural complications are not uncommon, but your symptoms seem more severe than typical reactions. The high ASCA levels suggest some form of intestinal inflammation, which can be puzzling without a clear diagnosis like Crohn’s disease. Additionally, conditions such as Mast Cell Activation Syndrome (MCAS) could contribute to your symptoms, especially in the context of your gastrointestinal distress following endoscopy.
Prioritized Next Steps:
-
Dietary Adjustments:
- Low FODMAP Diet: This can help reduce gastrointestinal discomfort. Focus on easily digestible foods and avoid high-FODMAP foods (like certain fruits, vegetables, dairy products, and grains) which may exacerbate your condition.
- Stay Hydrated: Especially with POTS, maintaining hydration helps manage symptoms of dizziness and fatigue.
-
Manage POTS Symptoms:
- Increase Salt and Fluid Intake: Consulting with your healthcare provider about adjusting your salt and fluid intake can help alleviate some POTS-related symptoms.
- Compression Garments: Wearing compression stockings can help improve blood flow and reduce symptoms of POTS by preventing blood from pooling in your legs.
-
Nutritional Support:
- Address Deficiencies: Work with a nutritionist to ensure you’re meeting your nutrient requirements, especially since you’re addressing copper and ceruloplasmin deficiencies.
- Vitamins and Supplements: Continue your regimen but consider discussing any changes or additional support with your healthcare provider to avoid overlaps or interactions.
-
Consider Testing for MCAS or Other Conditions:
- MAST Cells Testing: Look into specific tests that can confirm or rule out MCAS, which may explain some of your gastrointestinal symptoms.
- Additional Autoimmune and Inflammatory Tests: Given the ANA results, it may be worthwhile to further explore other autoimmune conditions or a detailed workup for systemic inflammation.
-
Symptom Diary:
- Track Your Symptoms: Keep a daily log of your symptoms, foods consumed, and any potential triggers. This can help you and your healthcare providers identify patterns or correlations.
-
Mental Health Support:
- Therapy Options: Even if anxiety was not previously a concern, the stress of ongoing health issues can be significant. Consider speaking with a mental health professional who can provide support.
Reassurance:
It’s completely reasonable to feel overwhelmed given how much you've been through recently. You are taking proactive steps by seeking out information and exploring your health concerns, which is commendable. It may take time to find the right combination of treatments and lifestyle adjustments that work for you, and that’s okay. Please continue to advocate for yourself and consider following up with your healthcare team regularly for further evaluation and support. Don’t hesitate to reach out if you have more questions or need further assistance!
Related Questions
Struggling with Fatigue and Low Spirits
I am a 27-year-old male whose first language is not English. A psychologist with two decades of experience in autism has diagnosed me with this condition. I previously took olanzapine, which caused an unusually long sleep of 20 hours during my first dose; however, I’ve stopped using it since then. While I was taking a sublingual form of vitamin B12 (methylcobalamin) at a dosage of 1000 mcg, my serum level registered at 290 pg/mL. This led to an unexpected surge of energy accompanied by feelings of anxiety and restlessness that I couldn't quite articulate, lasting for over six hours. I suspect that I might have a particularly sensitive nervous system. I'm contemplating whether to resume my B12 supplementation, as well as starting vitamin D3 at a dose of 2000 IU. Prior to taking D3, I found my levels to be very low, around 15 pg, though I can't recall the European unit it corresponds to at the moment. Additionally, my TSH level has been measured at 4, and I've been diagnosed with Hashimoto's disease. I’m currently at a loss as to why I continue to experience fatigue and a low mood. Does anyone have suggestions or insights that could help?
Chronic Leg Discomfort Since Childhood
I am a 14-year-old female who has experienced persistent discomfort in my legs for as long as I can recall, and the cause remains unclear. The maximum duration I can manage to walk without feeling faint is around 10 minutes, while I can only walk for about 5 minutes without needing to pause. Even when I’m at rest, I feel a dull ache in my legs, despite the rest of my body feeling relaxed. This discomfort predominantly occurs around my joints, particularly my knees and ankles, although my calves also become tender with minimal exertion. My feet tend to be perpetually cold, rarely warming up even when the rest of my body does. During my menstrual periods, I find it extremely difficult to walk, often having to hold onto walls just to navigate short distances. I've always maintained a healthy weight and I don't consider myself unhealthy overall. The only medical condition I’ve been officially diagnosed with is autism, although I'm unsure if this has any relevance to my symptoms.
Seeking Help for My 5-Year-Old Son with Autism and Constipation Issues
Hello, I am reaching out regarding my 5-year-old son who is non-verbal and has autism. He also shows signs of ADHD, although this has not yet been officially diagnosed. Typically, he is very energetic, cheerful, and expressive. He thrives in his school environment, where he is supported by a wonderful team of special education teachers. He doesn’t take any regular medications, except for melatonin to assist with his sleep. Recently, on December 19th, he developed a rash while at school, which resembled hives on his neck, face, and feet, with accompanying swelling in his hands. By the time we went to urgent care, the rash had disappeared, and he was given Benadryl. Unfortunately, the rash recurred a couple of times at home, though we only administered Benadryl on two occasions. Following this, during Christmas break, I noticed he became increasingly emotional, crying daily, appearing more fatigued, and having less energy overall, although he was usually still able to be comforted. I visited the pediatrician twice during this period, and lab tests came back normal, except for a positive COVID-19 result. The doctor prescribed guanfacine and clonidine for him (I apologize if I spelled those incorrectly), but I chose not to give him these medications since they weren't intended for behavioral issues. When school resumed, for the most part, he seemed to manage well until last week when he experienced another rash episode at school, occurring twice. I decided to try a non-drowsy allergy medication for him, but his emotional state deteriorated again, leading him to cry throughout the school day. His teachers expressed concern, stating that he appeared to be in discomfort, which they confirmed is not related to behavioral issues. At home, he has been very upset and inconsolable. As a result, I took him to the hospital yesterday. They sedated him for a head CT and abdominal ultrasound, both of which showed no abnormalities. They prescribed Miralax and suggested looking into ABA therapy since his autism diagnosis may automatically point to behavioral factors, which frustrated me. Today, he has spent the entire day crying and has remained in bed, clearly exhausted. I am administering the Miralax, and he seems visibly uncomfortable, but he hasn't had a bowel movement yet. His last stool was two days ago, and only a tiny amount has come out since then. I’m uncertain if the rash and his current symptoms are related to constipation or if I am missing a more serious issue entirely. This is very distressing. We have a dental appointment scheduled for Tuesday to rule out any dental issues, our fourth visit with the pediatrician on Wednesday, and a phone consultation with an allergist also on Wednesday. I would greatly appreciate any insights or questions I should bring up during our pediatrician visit, as well as any tips or suggestions. I'm feeling quite desperate for help. Thank you!
Nosebleed Episode After Extended Dry Heaving
I’m a 28-year-old male, standing at 5'7.5" and weighing 280 pounds. My background is Jewish, though I don't believe that detail is particularly relevant here. I deal with various health conditions including Postural Orthostatic Tachycardia Syndrome (POTS), potential May-Thurner syndrome (still under evaluation by my doctor), restless leg syndrome, sciatica, spinal stenosis, plantar fasciitis, along with a range of mental health challenges. My current medications consist of minoxidil, lamotrigine, bupropion, and a low dosage of Xanax. Greetings everyone! I have been struggling with relentless bouts of retching—primarily dry heaves, akin to ‘morning sickness’—that have persisted throughout January and into February. I can’t pinpoint any changes in my diet, medications, or lifestyle that could have triggered this episode. Interestingly, I don't usually feel nausea in my belly; instead, it manifests mostly in my throat and chest. Although I suffer from GERD, this is an unusual level of discomfort for me. I normally manage it with calcium supplements and occasional omeprazole, but I keep that to a minimum to avoid additional stomach issues. Despite my efforts, my dietary choices aren't particularly acidic. I find myself expelling mostly saliva and stomach acid rather than actual food. Zofran hasn’t alleviated the persistent nausea I’m experiencing. I consulted my primary care physician about these issues, but unfortunately, his recommendations weren’t helpful. He implies that my nausea stems from not maintaining a proper diet, suggesting that if I could just afford better food, I wouldn’t have this problem. He was far from supportive, and to make matters worse, every GI clinic nearby isn't accepting new patients for months, so finding a specialist has been quite challenging. Today, during another episode of retching, I finally ended up vomiting a small piece of apple along with the usual saliva and stomach acid. This was alarming, but even more concerning was the sudden onset of a severe nosebleed. It wasn’t a mere trickle; blood was pouring from my nose, staining my chin and dripping onto the floor. I hurried to the bathroom and managed to curb the bleeding within five minutes, but the experience rattled me considerably. I felt dizzy and unsteady throughout the day following this incident. Could there be a link between the excessive vomiting and the nosebleed? Is it possible that such intense straining caused a rupture in a blood vessel in my nose? Additionally, I’m curious if anyone has insight into the cause of my persistent nausea. With the recent bleeding, my speculation leans towards an irritation in my sinuses causing me to unknowingly swallow blood at night, contributing to the nausea. Despite retching five to ten times daily, this sudden, severe bleeding is a new development. Thanks in advance for any advice or suggestions; apologies for the lengthy post!
Dealing with Nausea and Vomiting
Hello, I'm a 16-year-old male. For the last five hours, I've been experiencing persistent vomiting accompanied by feelings of nausea. Could anyone share some tips on how to alleviate this condition?