OpenHealth Q&A

Seeking Answers for Ongoing Gastrointestinal Issues

Greetings, I’m an 18-year-old female, standing at 174 cm and weighing 63 kg. For the past year, I have been enduring persistent abdominal pain accompanied by diarrhea, yet I have not experienced any weight loss. This situation began following a grueling regime of nine different antibiotics prescribed for my recurrent tonsillitis, which occurred monthly over the course of six months. The final round of antibiotics was administered to treat tonsillitis, pneumonia, and appendicitis. Shortly thereafter, I started experiencing abdominal pain and diarrhea, although the symptoms were manageable and responded well to Imodium. Around six months later, I faced a second bout of appendicitis after having received antibiotics twice for tonsillitis in the interim. This time I required surgery; fortunately, the inflammation was minor, but doctors discovered mesenteric lymphadenitis, an inflammation of the lymph nodes, prompting a referral to the gastroenterology department. Following my appendectomy, the situation took a turn for the worse, with persistent diarrhea and abdominal discomfort lasting over six months. The pain predominantly occurs on the right side of my abdomen, where mild mesenteric lymphadenitis persists per ultrasound results. Additionally, I experience stabbing pains near my belly button and in the lower right quadrant after bowel movements. I often feel exhausted, never truly refreshed upon waking. Every morning is marked by abdominal pain and diarrhea, with the most severe symptoms occurring after meals, resulting in loose stools within 10 to 15 minutes. Although I am uncertain if there’s blood in my stool, I have noticed rectal bleeding. Lately, I’ve experienced elevated body temperatures and sore joints, along with increased tingling sensations in my limbs. I underwent a gastroscopy and colonoscopy; both procedures yielded no significant findings. Blood and stool tests showed my CRP was around 9, while my calprotectin level reached 1,188. Initially, my doctor suspected ulcerative colitis; however, a subsequent colonoscopy returned negative results. In response to my symptoms, my physician prescribed medications for irritable bowel syndrome, including Duspatalin Retard, which had previously been ineffective. I was also given Entizol and Normix antibiotics, Cipralex for anxiety, and probiotics like Mutaflor, along with Magnosolv and Vigantol for Vitamin D supplementation. Additionally, I take Zodac for seasonal allergies, contraceptive pills (Leverette), and Iron (Maltofer) to combat anemia, which has improved over the years, though I stopped iron supplements recently due to their potential to cause diarrhea. After a week of taking my new medications, I haven't observed any positive changes; in fact, my diarrhea has worsened, and I am experiencing a slight fever around 37.2°C, accompanied by frequent dizziness. My discomfort after bowel movements has intensified—transitioning from dull pain to a heightened sensitivity. Currently, I am awaiting a CT scan as my doctor contemplates further actions, noting that there’s inflammation linked to mesenteric lymphadenitis surrounding the intestines despite the unremarkable colonoscopy. She plans to consult her colleagues for additional perspectives. I’m reaching out for help as I feel utterly drained by this ordeal.

Answers (1)

7/2/2025, 8:10:48 PM

OpenHealth AI

I'm sorry to hear about the challenging gastrointestinal issues you've been facing. Your symptoms and medical history indicate a complex situation, and it's understandable to feel overwhelmed. However, let's break down the key points and provide guidance that may help you manage your symptoms better while you wait for further evaluations.

Summary of Key Points

1. Persistent Symptoms: You're experiencing abdominal pain, diarrhea, and fatigue, particularly after meals.
2. Medical History: This includes multiple courses of antibiotics, appendicitis, and the discovery of mild mesenteric lymphadenitis.
3. Diagnostic Tests: You've undergone a gastroscopy and colonoscopy with no significant findings, yet blood tests indicate inflammation.
4. Current Medications: You've tried several treatments, including IBS medication, probiotics, and anxiety medication, but symptoms have worsened.

Explanation

Your abdominal pain and diarrhea may be linked to several factors, including the lingering effects of antibiotics disrupting your gut microbiome, the inflammation from mesenteric lymphadenitis, and possibly an underlying condition that hasn't been fully diagnosed. The elevated calprotectin level in your stool suggests an inflammatory process, which could align with conditions like IBS, Crohn's disease, or a post-infectious syndrome.

Actionable Next Steps

1. Dietary Modifications:

   • Elimination Diet: Consider reducing or eliminating high FODMAP foods (such as certain fruits, dairy, and wheat) temporarily to see if your symptoms improve. This diet can help manage IBS symptoms.
   • Hydration: Ensure you're drinking plenty of fluids, especially if you're experiencing diarrhea. Oral rehydration solutions can be beneficial to maintain electrolyte balance.
   • Small, Frequent Meals: Eating smaller portions more frequently may help minimize symptoms after meals.

2. Monitor Symptoms:

   • Keep a detailed diary of your food intake, symptoms, and any changes. Note the timing, severity, and any associated factors to identify potential triggers.

3. Medications Review:

   • Since your medications have not improved your condition significantly, it may be helpful to discuss alternative options with your doctor. Consider discussing possible adjustments for gastrointestinal management or the timing and combination of your current medications.

4. Relief for Abdominal Pain:

   • Heat pads may provide some relief from abdominal cramps.
   • Gentle activities like walking or yoga may help reduce tension in the bowel.

5. Follow-Up with Healthcare Team:

   • Stay in close communication with your doctor regarding your symptoms and any new developments, such as changes in bowel habits or pain intensity. The upcoming CT scan may provide more information.
   • If you experience new symptoms like worsening fever, increased joint pain, or severe abdominal pain, reach out to your healthcare provider promptly.

Final Note

It's crucial to continue advocating for yourself throughout this process, as ongoing symptoms warrant thorough investigation. You're doing well by seeking help and maintaining an open dialogue with your healthcare providers. Please keep me posted on any changes or responses to these steps.