Could This Be IBS, or Something Different?
A 33-year-old female, who doesn’t smoke and has a history of a hiatal hernia and asthma, is experiencing ongoing health issues since May 2022. I'm inquiring on behalf of my partner, who has been struggling with these symptoms for quite some time. After undergoing a colonoscopy in July 2022, the results were normal. Despite several visits to the doctor and being given a variety of recommendations, none have proven effective. Notably, her symptoms do not appear to be associated with either dietary choices or stress. The episodes last anywhere from one to two weeks, during which she may need to use the restroom up to fifteen times daily. There are instances of bright red blood, typically occurring after several days of frequent bowel activity. These flare-ups are often accompanied by fatigue, an overall sense of malaise, and occasionally nausea, particularly when the pain intensifies. Although the medical professionals have suggested IBS as a probable diagnosis, her condition frequently disrupts her sleep. Based on my research, IBS is not typically linked with the presence of blood. Any insights would be appreciated. Furthermore, during the initial flare-up in 2022, her calprotectin level measured over 800. A subsequent test last year indicated a significant decrease, now around 70.
Answers (1)
7/31/2025, 1:20:43 PM
OpenHealth AI
Your partner's symptoms indicate a complex situation, especially with the history of ongoing digestive issues, high calprotectin levels, and the presence of blood in the stool. It's good that she has seen doctors and undergone necessary tests, as this is vital for effective management.
Main Points:
- Consider the Potential for Inflammatory Bowel Disease (IBD): The high calprotectin level suggests inflammation in the intestines, which might indicate conditions like Crohn's disease or ulcerative colitis rather than IBS.
- Monitor Symptoms Closely: It's essential to keep track of symptom patterns, especially concerning bowel habits and any associated symptoms like fatigue or nausea.
- Evaluate Current Management: Given that past treatments have been ineffective, a review might be necessary to reassess her management plan.
Explanation:
Irritable Bowel Syndrome (IBS) typically doesn’t cause blood in stools; the presence of blood alongside such frequent bowel movements raises concerns about other gastrointestinal conditions, such as IBD. Your partner’s high calprotectin levels suggest significant inflammation, which could warrant further investigation.
Next Steps:
- Symptom Diary: Encourage her to maintain a detailed diary of her symptoms, noting everything from bowel habits to fatigue levels, and any foods consumed. This may help identify patterns or triggers.
- Follow-up Testing: Request further evaluation with her healthcare provider, focusing on a review of her calprotectin levels and possibly additional imaging (like an MRI or endoscopy) to evaluate for possible bowel conditions.
- Hydration and Nutrition: Ensure she stays well-hydrated, especially considering the frequent bowel movements. A nutritionist may provide helpful guidance on maintaining a balanced diet.
- Symptom Management: Explore over-the-counter options for managing symptoms, such as anti-diarrheal medications, but consult with her doctor before introducing new treatments.
By closely monitoring her symptoms and ensuring a thorough investigation into her condition, your partner can work towards better management and relief from her distressing symptoms. Let me know if you need more insights or specific advice!
Related Questions
Concerns About Vaginal Bleeding While on Zolodex
Hello everyone, I'm a 20-year-old female from Australia diagnosed with endometriosis. I've been undergoing treatment with Zolodex for the past three months. When taking Zolodex, one should not experience menstrual periods as it induces a state akin to chemical menopause. Having completed three months of treatment, I can confirm I am indeed in that menopausal state. I understand that light bleeding can occur roughly two weeks after the initial dose—I experienced that—but once the medication takes effect, ovulation halts, and menstrual cycles cease. Recently, I experienced significant vaginal bleeding that began yesterday, accompanied by heightened pelvic discomfort. This situation is puzzling to me. I am fully aware that I cannot be menstruating while on this medication, and it’s evident that the Zolodex is effective, given the menopause-like symptoms I’m currently facing. My last injection was two weeks ago, and I’m not scheduled for another dose for another two weeks. I am seeking guidance on what steps to take next. The pelvic pain is not something unfamiliar to me; it has intensified slightly in my lower back along with some bloating. However, I don’t exhibit any other alarming symptoms that would suggest an urgent medical situation. Any insights or advice would be greatly appreciated. Thank you!
Understanding Blood Pooling in the Ankles
I’m a 32-year-old female, weighing 110 kg, a non-smoker who enjoys social drinking, and I’ve been grappling with this problem for approximately two years. Roughly two years ago, I noticed some redness appearing on the skin just above my ankles. At that time, I was working outdoors, leading me to believe it was a reaction to the cold weather. Unfortunately, the situation has progressively worsened. Despite being aware of my weight issue, I’ve experienced more significant weight fluctuations in the past without facing this problem. Currently, I am working on my weight loss, yet there’s been no noticeable improvement in my symptoms. After consulting with my general practitioner, I was informed that it might be related to poor circulation. However, the steroid cream and moisturizer prescribed have not yielded any results. I’ve also tried wearing compression socks consistently, but they did not help. I’ve found some temporary relief if I elevate my legs, but as soon as I lower them, the symptoms return. Rubbing the affected area also seems to relieve the redness for a few moments. Is there anyone who can shed light on what might be causing this issue, especially since I am otherwise young and in good health?
Anxiety About Moving Amid Ongoing Health Concerns
I am a 20-year-old experiencing distressing yet mild symptoms that have persisted for nearly five months. My personal history includes severe anxiety, which complicates my perception of physical sensations. While my symptoms can be random, what troubles me profoundly is my consistent feeling of unease whenever I engage in any physical activity or exertion. Whenever I stand or move about, I often feel a wave of lightheadedness or dizziness. Generally, it feels more like my body is faint and lacks strength rather than nearing complete unconsciousness. It’s important to note that I've experienced true presyncope—such as blurred vision and muffled hearing—only a few times, specifically after giving blood and once during physical education class as a child in hot weather. Additionally, I frequently contend with peculiar symptoms that may not always relate to my chest. Sometimes, I do experience mild chest sensations—such as slight tightness on the left side, a feeling of fullness, or occasional soreness. On other occasions, I encounter symptoms like pressure in my head and ears, vision disturbances (which I suspect may be related to dissociation), or a sensation of breathlessness, though I’m not gasping for air; it just feels like my airways are constricted or odd in sensation. I have considered the possibility of Postural Orthostatic Tachycardia Syndrome (POTS) due to my heart rate spiking over 40 beats per minute simply from standing, yet at other times my heart rate remains stable. My symptoms do vary from day to day, and they tend to lessen in the evening. I am aware of my physical deconditioning; prior to the intensification of my symptoms and anxiety, I led a relatively inactive lifestyle. About two weeks ago, I attempted a gentle 10-minute exercise designed for seniors, and it left me sore, with my heart rate reaching 190 BPM. Nowadays, I restrict my "exercise" to short walks around my home or yard for a few minutes several times throughout the day, minimal yoga, food preparation, and maintaining personal hygiene. As someone recovering from agoraphobia, I seldom venture out except for pre-planned therapeutic exposures. With my moving day looming just two days away, I’m terrified that the entire process could lead to hospitalization. Recently, I've started packing lightly for 30 to 60 minutes each day, but by the end, I often feel so exhausted that I need to stop. Accompanying this fatigue, there is often discomfort in my chest ranging from fleeting tight sensations to dull soreness, particularly on the left side. Almost invariably, I experience some level of discomfort, which understandably frightens me. Alongside this, I frequently experience feelings of air hunger or dyspnea, although I am aware that oxygen levels typically remain normal, indicating that the sensation might be perceived rather than physical. It’s worth noting that while the discomfort may differ in intensity, it seldom escalates to something severe—a minor irritant that naturally raises concerns due to its location. I tend to believe these ongoing symptoms relate to the stress of moving, although my anxiety has exacerbated my focus on the sensations. Unfortunately, my anxiety has hindered my ability to contribute significantly to the packing processes. In the last few days, packing has been minimized due to its near completion, yet I feel an ominous calm before the upheaval. While my physical activity has decreased, my chest discomfort seems more persistent, ranging from a general tightness in my upper chest and neck to that dull, often painless tension on the left side. Fatigue and feelings of dissociation have escalated as well. Sometimes, the discomfort appears after certain movements, while at other times it arises unexpectedly. There were several occasions where I experienced lingering tightness in the left side of my chest, lasting 1-2 hours while resting before fading completely. I have noticed flare-ups of both chest discomfort and fatigue, oscillating in severity over the past months. Each day feels like a challenge as I navigate simple tasks that have begun to feel “risky” due to these worrying symptoms; yesterday, I even felt affected while taking out the trash and playing the piano. Currently, I am in the process of finding a new primary care physician (PCP) since my previous one shut their practice, but the next available appointment won’t be for at least a couple of weeks—definitely not before the move. At the end of March, I had a telemedicine appointment and some bloodwork done, yet there were no definitive answers; just minor abnormalities. I’m uncertain whether my symptoms signal a cardiac issue, but that remains my primary concern. Two years ago, I underwent a normal EKG and Holter monitor, yet I do not believe that fully excludes potential problems, so I plan to request a referral for another cardiologist when I secure a new PCP. I’m at a loss for what to do. I want to be helpful on moving day, yet the anxiety makes me feel as though I won’t be able to contribute effectively out of fear regarding my safety. I’m even contemplating whether I should seek urgent care before the move, but I worry the only outcome would be an EKG and blood test—neither of which would necessarily alleviate my uncertainty. I dread the thought of ending up in the emergency room during the move. If that day weren’t approaching, I would likely just wait for my new PCP appointment, but the urgency of the situation makes me want to find some reassurance before then.
Understanding Elevated Kappa to Lambda Light Chain Ratio
A 24-year-old female from the UK, weighing 147 pounds, has been grappling with serious health issues since the onset of 2024. She received a diagnosis of Hypermobile Ehlers-Danlos Syndrome at the Royal National Orthopaedic Hospital (RNOH) along with pelvic organ prolapse that includes both small bowel and rectal components, bowel dyssynergia, and hypertonic pelvic floor dysfunction. Her current medication regimen includes Linaclotide, Tramadol, and Baclofen. Earlier this year, her IgG levels fell to 5.4, subsequently dropping to 5.1, though recent blood analysis indicated a recovery back to 5.4. Following this, hematology requested further assessments including serum protein electrophoresis and light chain measurements. Although she has not taken steroids or immunosuppressants, nor has she experienced known infections this year, she reports a prolonged period of feeling unwell. She has not identified any kidney complications. Previously low ferritin levels have been addressed, albeit only marginally. Last year's autoimmune tests showed no evidence of inflammation. Could anyone offer insights on this situation? How alarmed should I be regarding these results? The possibility of seronegative Sjögren’s syndrome is something I find conceivable. - Serum lambda light chain concentration: 9.1 mg/L - Serum kappa light chain concentration: 28.4 mg/L - Kappa to lambda light chain ratio: 3.12 (normal reference range: 0.26 - 1.65); indicates values above the established high limit. It's important to interpret free light chain (FLC) results alongside other laboratory findings and clinical history. Note that renal impairment may hinder FLC clearance, with the renal reference range for the FLC ratio being 0.37-3.10. Significantly elevated antigen levels could lead to skewed low FLC results. - Serum protein electrophoresis shows a decline in gamma globulins, as reflected in the electrophoretic pattern. A urine specimen is needed for further investigation regarding Bence Jones protein.
Elevated Kappa to Lambda Light Chain Ratio: A Closer Look
A 24-year-old female from the UK, weighing 147 pounds, has faced considerable health challenges since early 2024. She has been clinically diagnosed with Hypermobile Ehlers-Danlos Syndrome at the Royal National Orthopaedic Hospital, as well as experiencing a pelvic organ prolapse affecting both the small intestine and rectum. Additionally, she has bowel dyssynergia and hypertonic pelvic floor dysfunction. Her current medications include Linaclotide, Tramadol, and Baclofen. Earlier this year, her IgG levels fell from 5.4 to 5.1, but the latest blood work indicates a return to 5.4. Following this, Hematology requested tests for serum protein electrophoresis and light chain levels. She has not taken steroids or immunosuppressants and hasn’t had any known infections this year, yet her overall well-being has been poor for a prolonged period. There are no known kidney issues at this time. Although she previously had low ferritin levels, she has managed to increase them slightly. Furthermore, autoimmune screenings conducted last year did not show signs of inflammation. Given these circumstances, she is seeking insights into her current health situation and the implications of her laboratory results, expressing particular concern regarding the elevated kappa to lambda light chain ratio, which could indicate seronegative Sjögren’s syndrome. Key laboratory findings include: - Serum lambda light chain level: 9.1 mg/L - Serum kappa light chain level: 28.4 mg/L - Kappa to lambda light chain ratio: 3.12 (reference range: 0.26 - 1.65), indicating levels above the normative threshold. It is important to interpret free light chain (FLC) results in conjunction with other laboratory tests and the patient's clinical history, noting that renal impairment can hinder FLC clearance and that an excessive concentration of antigens may inflate the FLC results, leading to misleadingly low values. Additionally, serum protein electrophoresis indicated a reduction in gamma globulins, prompting the need for further investigation of urine samples for Bence Jones Protein.