OpenHealth Q&A

Navigating Chronic Digestive Issues: Seeking Guidance After Past Dismissals

At 29 years old and weighing 154 pounds (or 70 kilograms for those using the metric system), I recognize that my weight class still categorizes me as obese. However, I remain dedicated to shedding excess pounds and have successfully lost 44 pounds (20 kilograms) thus far. My medical background includes diagnoses of PCOS, ADHD, Generalized Anxiety Disorder, and Complex PTSD. I do not engage in alcohol consumption, smoking, or the use of illicit substances. Currently, I am prescribed Lisdexamfetamine (30 mg) to manage ADHD, alongside hormonal contraceptives. I have some uncertainty regarding food allergies, having experienced adverse reactions in the past, but I suspect talcum powder might be a common ingredient in medications that have led to issues. A significant concern for me has always been my severe gastrointestinal problems, which I first noticed around the age of five. My symptoms can be debilitating, resulting in intense pain that occasionally leads to vomiting or feelings of dizziness, akin to fainting—though this has only occurred once. Notably, the pain subsides almost immediately after a bowel movement, which often consists of watery stools. Although the pain typically fades, I frequently find myself making multiple trips to the bathroom for hours afterwards. On the flip side, there are times when I become constipated for days, accompanied by significant gas pain. When I finally do manage to have a bowel movement, it’s often followed again by urgent trips to the restroom. Identifying triggers for my symptoms is a puzzle. I’ve tried various diets and sought advice from dietitians to figure out food-related triggers; however, I find little consistency. A food that may not provoke any issues one day could lead to a flare-up the next, with the same unpredictability for beverages. Certain stimulants like coffee invariably stimulate my bowels. My anxiety also plays a role: during periods of high stress, my stomach issues flare up and prompt an urgent need to use the bathroom. Usually, these episodes last no more than a few hours unless I become dehydrated, in which case addressing my hydration typically alleviates the discomfort. In terms of medical evaluations, I have only undergone blood testing. My previous physician opted against referring me for a colonoscopy, believing that my blood results indicated no risk for Coeliac disease and that I likely have Irritable Bowel Syndrome (IBS). A notable test showed my C-reactive protein (CRP) level was elevated at 17, which suggests potential inflammatory activity, although the tests are generally more sensitive to acute responses than others. Since changing doctors, we conduct blood tests every three to six months, though the reactive protein has yet to be re-evaluated. Tests have shown persistently low iron levels that are improving, slightly low Vitamin D, high platelets at 506, and elevated cholesterol, which my new doctor has emphasized given my obesity. Levels of urea and albumin are just marginally below the normal range, perhaps due to previous medication that affected my liver, which I ceased after seeing concerning results. Why have I hesitated to discuss my ongoing symptoms with my new GP? My past experiences with healthcare have left me feeling dismissed; each doctor I encountered assured me that I was in good health despite previous blood tests suggesting deficiencies. It’s been a challenge to accept the notion of a physician who appears genuinely invested in addressing my health concerns. As far as my family history goes, my mother has also been diagnosed with IBS, mirroring my own digestive struggles. I’m at a crossroads now: what steps should I take moving forward? How can I effectively voice my worries during my next appointment? Would additional blood work help to clarify the situation, leading to further examinations if needed? Are there over-the-counter solutions available to help manage my frequent restroom visits? While I work from home, I constantly feel the pressure of needing a bathroom when engaging in outside activities, prompting a rush to return home.

Answers (1)

3/26/2025, 9:50:45 PM

OpenHealth AI

It sounds like you're facing a complex mix of chronic digestive issues and worries about your overall health, especially with your history of dismissals from healthcare providers. Your conscientious approach to managing your health, combined with your dedication to weight loss, shows a lot of resilience. Here's how you can proceed moving forward:

Overview of Key Points

1. Chronic Digestive Issues: You may have symptoms consistent with Irritable Bowel Syndrome (IBS), considering the alternating patterns of diarrhea and constipation, along with pain relief after bowel movements.
2. Communication with Healthcare Providers: It’s important to express your concerns clearly and assertively, as you deserve to be heard and supported in managing your symptoms.
3. Next Steps and Self-Care: There are practical measures you can take to address your symptoms and improve your quality of life.

Explanation

IBS is a functional gastrointestinal disorder which often presents with symptoms like yours. It can be influenced by stress levels and dietary factors, making management challenging. The variety of symptoms, including inflammation markers and past medication effects, also suggest that attention to your overall health and lifestyle may be essential.

Prioritized Next Steps

1. Document Your Symptoms:

   • Keep a daily log of your symptoms, including what you eat and drink, your stress levels, and any gastrointestinal reactions. Note the timing and nature of bowel movements (diarrhea vs. constipation). This will help you and your doctor identify potential triggers and patterns.

2. Schedule an Appointment with Your GP:

   • Prepare for your next visit by bringing your symptom diary. This will help demonstrate the severity and variability of your symptoms. Start with something like, "I've been tracking my symptoms and wanted to discuss some persistent issues that affect my daily life."

3. Discuss Potential Tests:

   • Ask for a re-evaluation of your C-reactive protein (CRP) levels and mention your low iron and vitamin D levels. A referral for additional testing, such as a colonoscopy or consult with a gastroenterologist, could clarify your diagnosis and rule out other conditions.

4. Discuss Management Options:

   • Inquire about dietary approaches specifically for IBS, like the low-FODMAP diet, which may help identify food triggers. Over-the-counter treatments such as probiotics or anti-diarrheal medications might also help manage symptoms—ask your doctor if these could be appropriate for you.

5. Consider Stress Management Techniques:

   • Since you mentioned that anxiety exacerbates your symptoms, integrating stress-reduction strategies, such as mindfulness, yoga, or therapy, may provide additional relief.

6. Hydration:

   • Since dehydration worsens symptoms, prioritize staying hydrated, especially if you are experiencing diarrhea. Electrolyte solutions can be beneficial during these times.

Empathy and Reassurance

Navigating health issues, especially with a long history like yours, can be frustrating and exhausting. It’s completely valid to feel hesitant after past experiences. Remember that you deserve care that respects your experiences and addresses your concerns directly. By advocating for yourself with detailed documentation and targeted questions, you’re taking a strong step forward. You are not alone in this journey, and with the right support, you can find a path that leads to better management of your symptoms and overall health.