Seeking Insights on Ongoing Symptoms
Hello everyone, I’m a 23-year-old female, and I recently underwent a colonoscopy last Thursday, but it has left me with even more uncertainty regarding my health. For the past three months, I have been grappling with several troubling symptoms. These include stools that are often pencil-thin—sometimes accompanied by bright red blood—severe constipation that can last for days, followed by bouts of diarrhea. I've also been experiencing a significant loss of appetite that resulted in a weight drop of 15 pounds since early May. Exhaustion haunts me, as I often find myself taking 4-6 hour naps on my days off yet still feeling drained afterwards. Other concerns include shortness of breath, painful backaches, daily nausea, a frequent urge to use the bathroom, hair thinning, bloating, and extreme belching. Due to my family’s history with colon cancer, fear consumed me; I was convinced that I had a few months left to live. This anxiety prompted me to quickly secure an appointment with a gastroenterologist recommended by the emergency room after I sought help for severe pain and constipation on May 5th. They performed a CT scan, which came back normal, and an ultrasound indicated the presence of multiple small ovarian cysts. A doctor at the ER identified one of these as having ruptured on the same day, but the symptoms continued, albeit with a milder sense of abdominal discomfort that just won't go away. After my colonoscopy, the only findings were one internal and one external hemorrhoid, which sounds like good news because it rules out cancer. However, the doctor didn’t provide much clarification during our brief conversation. He suggested I might have lactose intolerance, advised seeing a gynecologist, and sent me on my way. While it’s a relief that there’s no cancer involved, I’m left puzzled about how this addresses the unusual symptoms I’m experiencing. Why have I been observing consistently pencil-thin stools for three months? I monitor my stools each time I manage to go. Hemorrhoids don’t seem to account for this condition, at least not in the long run, do they? Could potential lactose intolerance be a contributing factor? If everything is somehow linked to gynecological issues, could that also cause my stool shape? I'm in a state of confusion! Thank you for taking the time to read my post!
Answers (1)
8/3/2025, 5:10:49 AM
OpenHealth AI
It's understandable to feel overwhelmed given the range of symptoms you've been experiencing; it’s commendable that you are seeking clarity. Let's break down the key points regarding your symptoms and what you might consider next.
Main Points:
- Your symptoms, including pencil-thin stools and blood, can be concerning.
- Recent tests (colonoscopy and CT scan) have largely ruled out serious conditions like cancer, but your ongoing symptoms merit further exploration.
- Potential lactose intolerance and gynecological issues may play a role, and understanding these can help address your concerns.
Explanation:
Pencil-thin stools can indicate various issues, often related to the colon. While hemorrhoids can cause changes in stool shape, other conditions, including inflammation or narrowing of the colon (such as in IBS or IBD), should also be considered. The presence of bright red blood can be due to hemorrhoids, fissures, or other factors but should not be ignored—especially in conjunction with your history.
Lactose intolerance can cause gastrointestinal symptoms like bloating and diarrhea, but it typically does not cause changes in stool shape. Your symptoms of fatigue, significant weight loss, and shortness of breath require further attention, as they may point to systemic issues that should be investigated more comprehensively.
Next Steps:
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Dietary Adjustments: Consider eliminating dairy products for a period to see if symptoms improve, especially since lactose intolerance was suggested. Keeping a food diary may help you identify any other food sensitivities.
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Hydration & Fiber: Ensure you are drinking plenty of water and include more fiber in your diet if possible to help with constipation. Gradual changes can be beneficial, as sudden increases in fiber can also worsen bloating.
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Monitor Symptoms: Keep a detailed record of all your symptoms, including stool shape, frequency, any pain, and your energy levels. This information will be crucial for your healthcare provider to understand the pattern and severity of your symptoms.
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Follow Up: Given the complexity of your symptoms and the potential connections to gynecological issues, consider following up with both your gastroenterologist for further evaluation of your colon and possibly a gynecologist to discuss the ovarian cysts and any hormonal imbalances that may be contributing to your overall condition.
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Mental Health Support: Given the anxiety you've mentioned related to your health concerns, consider seeking support from a mental health professional. Managing stress and anxiety can have positive effects on overall health.
These steps should help you start feeling more in control of your symptoms and may guide you to a clearer understanding of their origins. Please don't hesitate to seek further medical advice and clarification regarding the tests and findings as you navigate this challenging time.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.