Navigating Malabsorption Concerns
A 24-year-old woman weighing 142 pounds and standing at 5 feet 7 inches is grappling with health issues surrounding malabsorption. Diagnosing such conditions can be quite challenging. Since 2018, she has been contending with a significant vitamin D deficiency; it plummeted to a mere 8 and has only recently improved to 23. In addition, she was diagnosed with Idiopathic Intracranial Hypertension (IIH) in 2022. Following this diagnosis and undergoing a lumbar puncture, as well as starting a daily regimen of 500 mg Diamox, there have been no further indications of cerebrospinal fluid accumulation. However, her health struggles do not stop there. She has been battling chronic sinusitis and rhinitis since 2013, stemming from a deviated septum, which unfortunately went undiagnosed due to inadequate parental oversight on routine check-ups. She is now addressing this lingering issue, but medications and antibiotics have not shown effectiveness, leaving her anxious about the possibility of requiring surgery. A notable concern is the presence of 1.5 inches of mucosal buildup in her right maxillary sinus. Compounding her difficulties, she is struggling with dehydration and an ongoing urinary tract infection (UTI) that emerged after starting Diamox. Despite her efforts to stay hydrated, the problem persists. In light of her UTI concerns affecting her kidney health, she has received a referral to an IV therapy center for additional support. Her current medication routine includes 250 mg of Diamox taken twice a day, doxycycline at 100 mg twice a day, Cymbalta at 30 mg twice daily, Buspar at 10 mg twice a day, a daily intake of 5000 units of vitamin D, 500 mg of B12, and a regimen of Pepcid 20 mg in the morning, Prilosec 20 mg in the evening, cefuroxime 500 mg, and Flonase administered twice a day. She is actively seeing an ENT specialist, an internist, a neurologist, and an OB/GYN, and has also been referred to both holistic and gastroenterology specialists.
Answers (1)
6/16/2025, 3:10:52 AM
OpenHealth AI
Key Points: Managing malabsorption and associated health issues can be complex, especially with conditions like vitamin D deficiency, chronic sinusitis, and recent urinary tract infections (UTIs). It's essential to focus on hydration, monitor symptoms, and consider dietary adjustments to address malabsorption.
Explanation: Malabsorption can lead to deficiencies in nutrients, which you've experienced, particularly with vitamin D. Chronic conditions like Idiopathic Intracranial Hypertension (IIH) and your ongoing sinus issues create additional layers of complexity. Your regimen is extensive and includes multiple medications, each targeting different symptoms and conditions. It’s crucial to ensure that your body is absorbing nutrients effectively while also staying hydrated.
Next Steps:
-
Hydration: Make hydration a top priority. Aim to drink at least 8-10 cups (64-80 ounces) of water daily. Consider oral rehydration solutions (like electrolyte drinks) to ensure you’re replacing lost fluids effectively, especially since you’re on Diamox, which can lead to increased urination.
-
Dietary Considerations: Focus on a nutrient-dense diet that is easy to digest to help with absorption. Include foods high in vitamins and minerals. Foods like avocados, nuts, leafy greens, and lean proteins can be beneficial. Avoid processed foods that can be harder to digest.
-
Lab Monitoring: Keep track of your vitamin D and B12 levels, along with any other nutrients that could be deficient due to malabsorption. Regular check-ups and labs can ensure any deficiencies are promptly addressed.
-
Addressing Sinus Issues: In collaboration with your ENT specialist, discuss options for managing the mucosal buildup. This may include potential surgical interventions if medications are ineffective.
-
UTI Management: Continue your course of doxycycline for UTIs while monitoring for symptoms. Keeping a symptom diary can be helpful for both you and your healthcare providers, especially regarding how your symptoms evolve in relation to your medications.
-
Follow-Up Care: Keep communication open with all your specialists. It may be beneficial to consolidate some of your care by asking if your providers can collaborate on your overall treatment plan, which could include nutritional counseling tailored to addressing malabsorption.
Remember, it's important to take each step one at a time and allow for some adjustments in your routine as you discover what works best for you. Don’t hesitate to reach out for support or clarification on any of these points as you navigate your health challenges.
Related Questions
Navigating MALS Challenges: Seeking Guidance
Hello everyone! I’m a 36-year-old female dealing with multiple health conditions, including EDS (Ehlers-Danlos Syndrome), MALS (Median Arcuate Ligament Syndrome), and ulcerative colitis, among several other unrelated issues. I wanted to share my experience with MALS, which has been confirmed for me. Back in May 2024, I underwent revision surgery. Unfortunately, the recovery did not go as hoped. Due to my EDS, the celiac artery lacks the ability to function independently, which my surgeon described as it being "too floppy." At that time, I accepted this outcome because the excruciating pain had subsided, and I was able to eat and gain weight again. However, now I find myself facing a resurgence of pain that is quite intense. A CT scan I had last week revealed severe stenosis in my celiac artery, coupled with a soft tissue prominence at the diaphragmatic crus and the beginning of the celiac axis. Currently, I’m taking Norco 10-325 three times a day and Lyrica 75 mg three times daily. While these medications provide some relief, the pain is overwhelming, and I can’t help but feel as if I’ve returned to my previous struggles from two years ago. Doctors are suggesting that the only option is to go in and "clean out the adhesions". I come to you all for your insights: Do you think pursuing a clean out procedure is advisable, or could it pose too much risk considering my EDS? I appreciate your thoughts and thanks for reading my story.
Hernia Diagnosis Without Follow-Up: A Conflicting Situation
A 22-year-old male recently visited the emergency room due to discomfort in his lower abdomen. Upon examination, the medical team was indecisive about whether he was experiencing an oblique muscle problem or a hernia. Surprisingly, they opted against performing a CT scan or ultrasound and did not schedule any follow-up appointments. To the best of my knowledge, hernias typically do not resolve themselves with merely the use of ace bandages or over-the-counter pain medication; surgical intervention is usually necessary for proper treatment. Is there a specific rationale behind their reluctance to pursue further diagnostic testing or surgery?
Unexplained Episodes of Abdominal Discomfort
Age: 28 Gender: Female Weight: 194 lbs Height: 5’7" Current Medications: Vitamin D, Fish Oil, B Complex Vitamins, Birth Control Pills, Vyvanse 30 mg Health Background: Asthma, Eczema, Gastroesophageal Reflux Disease (GERD) Since August 2025, I've experienced three occurrences of intense abdominal discomfort that necessitated visits to the emergency room for pain management. These episodes usually strike at night, escalating to unbearable levels within around 30 minutes. None of the sitting positions seem to provide relief, and gastrointestinal medications have proven largely ineffective. Only strong pain relievers seem to alleviate the suffering. After the peak of the pain subsides, my abdomen remains sensitive for more than three days. I can accurately identify the location of the discomfort, which appears to be between the midepigastric area and near the gallbladder. The pain is difficult to articulate, yet it presents as a severe burning and aching sensation. Interestingly, there does not seem to be any specific food intake related to these pain episodes. I underwent an H. Pylori breath test that returned negative results. Additionally, I had an esophagogastroduodenoscopy (EGD). Although the biopsies were also negative for H. Pylori, they did reveal residual liquid in my stomach and a small section of intestinal metaplasia. My complete blood count (CBC) and comprehensive metabolic panel (CMP) results were normal, except for elevated LDL levels, which I’m already aware of. My gastroenterologist has recommended a gastric emptying study (GES) to evaluate the functionality of my stomach. If results indicate no issues, we will then investigate the gallbladder. Are there alternative explanations for my symptoms? Should I be worried about autoimmune metaplastic atrophic gastritis (AMAG)? While I have been diagnosed with GERD, this pain feels distinctly different from the GERD-related discomfort. I am not entirely sure it is gastroparesis, even though I occasionally regurgitate if I eat too quickly; I do not experience nausea or malnutrition. I have researched extensively, and my symptoms align with biliary colic. However, I am anxious about the possibility of gallstones not appearing in the ultrasound. My gastroenterologist is not particularly concerned about the intestinal metaplasia, but being only 28 years old, I find this worrying. As a medical student, these painful episodes significantly hinder my studies and academic progress.
Understanding My Symptoms: A Personal Account
I’m sharing my experiences here, as I haven’t received much feedback elsewhere. I am a 15-year-old female, measuring about 5 feet tall (152 cm) and weighing between 105 and 110 pounds (47-50 kg). I identify as Hispanic and Cuban, and legally fall under the white classification. I reside in Palm Beach County, Florida, and I am a U.S. citizen. I have a diagnosis of Autism and previously had ADD, although that diagnosis has been dropped, which leaves me unsure about my current condition—whether ADHD applies or not. Additionally, I have a past history of anemia, although it is currently not diagnosed. For the past year, I've experienced a range of symptoms that appear intermittently and are often present almost daily. While these symptoms vary, they haven’t subsided. I’ve noticed that both physical activity and caffeine can either trigger or exacerbate these issues. Now, I’d like to detail the symptoms I've been facing. One of my major concerns is my balance; when I stand, I often feel unsteady, and sometimes I even limp. This particular symptom is quite troubling as it occurs frequently. I also experience occasional dizziness and fatigue, which leaves me feeling too weak to move, causing me to remain still for prolonged periods. During episodes of significant fatigue or balance issues, I find myself starting to stutter and I suspect my speech may slur at times. Additionally, my hands sometimes shake, especially when I struggle to walk. There could be other symptoms I haven’t recalled yet, but this is what I remember for now. I will provide updates if I think of anything else, and I welcome any engagement. Furthermore, I’ve noticed irregularities with my heart rate. Initially, when these symptoms began, my resting heart rate dropped from the 80s and 90s to the 50s and 60s; this lower rate has persisted. Lately, however, even simple tasks such as standing, walking short distances, or rocking back and forth (which I do as a self-soothing mechanism) have caused my heart rate to spike to the 100s. These changes are new, while the other symptoms have been consistent for about a year. I genuinely seek guidance or support, as I feel uneasy relying on AI for self-assessment. Unfortunately, I can't afford doctor visits at this time, and my caretaker has shown little concern for my well-being. Therefore, please refrain from suggesting medical consultations. Thank you for taking the time to read my story. I’m open to any questions.
What Could This Bump Be? Should I Be Concerned?
I’m a 22-year-old male, standing at 6 feet 2 inches tall and weighing 180 pounds. I currently don’t take any medications and have no significant medical history. Recently, I discovered two small, white bumps on my finger, which appeared around two days ago. They feel firm, much like the sensation of a splinter lodged underneath the skin, and they stick out slightly above the surface. One bump is located at the joint of one finger, while the other is positioned at the tip of another finger on my opposite hand. These bumps are neither painful nor bothersome, but I’m curious to know whether I should consider having them removed or if they might resolve on their own over time. I would appreciate any guidance regarding this matter. Thank you!