OpenHealth Q&A

Struggling with Chronic Abdominal Pain, Diarrhea & Cramps: A Long-Term Battle

At 28 years of age, my health journey has been fraught with challenges. I've had several medical diagnoses in recent years: Anxiety in 2018, ADHD in 2021, and IBS-D in 2022. Currently, I am prescribed a variety of medications: - Zofran 4mg - Lorazepam 1mg as needed (up to twice daily) - Hyoscamine 0.125mg every three hours - Dicyclomine 20mg taken three times a day I discontinued use of Adderall in 2022. In terms of dietary intake, I focus mainly on soluble fiber and take probiotics from the Garden of Life brand. My troubles began around 2019 when I started experiencing significant cramps, bloating, and diarrhea shortly after consuming dairy. After enduring these symptoms for about three months, I eliminated dairy from my diet. Later in 2019, I developed a pervasive, extremely itchy rash that my primary care physician tried to treat with creams to no avail. A thorough blood test revealed nothing unusual, and skin biopsies returned inconclusive results. Although I had long associated my consistently flushed cheeks with Rosacea, tests for lupus showed normal results. After about eight weeks, the rash inexplicably began to subside without an understanding of its cause. Through 2020 and 2021, my symptoms persisted without any drastic changes. A food allergy blood test conducted in 2021 yielded no detectable results. Additional lab evaluations included ferritin, complete blood count, thyroid panel, A1c, lipid profile, allergy testing, iron assessments, and comprehensive metabolic panel. The only notable issue was a deficiency in Vitamin D. In 2022, my situation compelled me to seek help from a gastroenterologist due to worsening cramps, bloating, and diarrhea after eating. At my worst, I experienced diarrhea upwards of 15 times a day, with bile become a frequent occurrence. Following the low-FODMAP dietary advice from my GI specialist, I increased my fiber intake. Due to concerns regarding my family history, I underwent a colonoscopy, which revealed and removed polyps; thankfully, test results came back normal. I was advised to continue my anxiety medication and find strategies to manage stress. The doctor prescribed Zofran, Dicyclomine, and Hyoscamine. By 2023, I noticed that I was becoming increasingly sensitive to various foods, particularly certain fruits (like red ones), tomatoes, garlic, onions, and specific vegetables and seasonings. Despite my efforts to manage these sensitivities, I continued to have diarrhea, which has lessened from 10-15 times daily to about 5-10, with persistent intense cramps and bile output. Accompanying symptoms included overwhelming fatigue, bloating, night sweats, unexplained weight gain, joint discomfort, and occasional difficulty swallowing, although these episodes were sporadic. In 2024, I began treatment with compounded semaglutide from IVIM, which reduced diarrhea frequency to 1-3 times daily. Despite improvements, I still faced night sweats and fatigue, alongside other ongoing symptoms. In 2025, I stopped my medications for financial reasons. Now, I find that even previously tolerated foods are making me feel ill. Foods I used to consider safe now cause immediate distress, leading me to avoid eating out for fear of needing a restroom urgently. Two months ago, I switched to a low-histamine diet, but I’m still reacting poorly to bland foods like chicken, rice, squash, zucchini, and carrots. My symptoms resumed, with diarrhea returning to 2-4 times each day, accompanied by brain fog, extreme fatigue, sweating, dizziness, and persistent abdominal issues. Remarkably, I can count on one hand the number of regular stools I've had this year, and I carefully monitor my fiber intake. It’s also worth noting that I do not smoke or consume alcohol, and fast food causes severe discomfort for me. In February, I underwent various tests—including a CBC, CMP, and gallbladder ultrasound—following a severe pain episode; all results were within normal ranges. I am now at a crossroads regarding my healthcare direction, especially since my gastroenterologist retired and I have recently obtained new insurance. I’m seeking advice on specific tests or lab work I should consider to move forward with my health concerns.

Answers (1)

8/10/2025, 10:01:59 PM

OpenHealth AI

Your experience with chronic abdominal pain, diarrhea, and other symptoms is understandably frustrating, especially after such a complex medical history. Seeing that you've made considerable efforts to manage your condition with lifestyle changes and dietary adjustments, it's important to identify actionable steps that may help improve your quality of life.

Main Points:

1. Consider Comprehensive Testing: Given your ongoing symptoms and the variety of reactions you're having to previously tolerated foods, specific tests may help clarify potential underlying issues.
2. Trial an Elimination Diet Methodically: Revisiting an elimination diet, but with a structured approach, could help identify new food sensitivities.
3. Reconnect with a Specialist: Finding a new gastroenterologist to develop a personalized management plan is crucial.

Explanation:

You’ve been through many tests and treatments that have ruled out some serious conditions but haven’t fully addressed the ongoing gastrointestinal issues. The sensitivity to foods, the presence of bile in stools, and your other symptoms could be indicative of an underlying condition that is not fully diagnosed or treated. Chronic symptoms like these often indicate that individualized, careful evaluation is needed to tailor management strategies.

Next Steps:

1. Testing:

   • Food Sensitivity Testing: Consider allergy and sensitivity testing for reactive foods, even if previous tests have been negative. New sensitivities can develop.
   • Celiac Disease Test: Given your gastrointestinal symptoms, testing for celiac disease (through blood tests and possibly a biopsy) could be worthwhile.
   • Stool Studies: Tests that evaluate fat and other substances in your stools can help assess malabsorption issues.
   • Hydrogen Breath Tests: These can help identify issues like lactose intolerance or small intestinal bacterial overgrowth (SIBO).

2. Dietary Adjustments:

   • Elimination Diet: Consider an elimination diet for specific food groups (like histamine-rich foods) and reintroduce them one at a time to monitor your reactions carefully. Keep a detailed food diary to track any symptoms that arise.
   • Consult a Dietitian: A specialist in gastrointestinal health can work with you to set up a balanced elimination diet and ensure you’re getting adequate nutrition while identifying triggers.

3. Find a New Gastroenterologist:

   • Look for a specialist with experience in functional gastrointestinal disorders and those who can provide a holistic approach to managing your IBS-D and potential food sensitivities.
   • Prepare a comprehensive overview of your history and symptoms to facilitate an effective consultation.

Supportive Measures:

• Stay Hydrated: Ensure you're drinking plenty of fluids, especially if experiencing diarrhea, to prevent dehydration.
• Stress Management: Given the known link between stress and gastrointestinal symptoms, incorporate stress-reduction techniques such as mindfulness, gentle exercise, or therapy into your routine.

Understanding your body and symptoms can be a long journey, but with dedicated testing and support, you can find a clearer pathway to management. Stay hopeful, and I wish you the best in navigating this challenging health landscape.