OpenHealth Q&A

Navigating Multiple Health Challenges: A Personal Perspective

I am a 60-year-old woman weighing 224 pounds and dealing with a collection of health issues including hypothyroidism, gastroparesis, migraines, bipolar disorder, ankylosing spondylitis, Reynaud’s phenomenon, a history of two transient ischemic attacks, GERD, severe obstructive sleep apnea, a removed gallbladder, and some kidney decline. My health situation is quite complicated. Currently, I am prescribed Synthroid, lithium, gabapentin, lamotrigine, Eliquis, Crestor, propranolol ER, levocetirizine, omeprazole (40 mg), Cocentyx (150 mg twice), Nurtec, and acetaminophen. I have struggled with irritable bowel syndrome (IBS) since I was 16 years old, with symptoms surfacing intermittently. During a pregnancy in 2000, an event seemingly exacerbated my health problems, likely due to exposure to a tick while camping, which may have kicked off an arthritic condition. Although my arthritis showed slight improvement during pregnancy, I gradually developed symptoms consistent with ankylosing spondylitis (AS), officially recognized in 2006, misdiagnosed in 2009, before finally receiving a confirmed diagnosis around 2011. Throughout the years, I've dealt with severe bouts of diarrhea. I have undergone several medical examinations, including at least four or five colonoscopies, an endoscopy, and capsule endoscopy, yet none provided conclusive results regarding my intestinal health. Despite the ongoing issues, my rheumatologist suspects I might have subclinical inflammatory bowel disease. For the last few years, diarrhea has become a frequent problem for me. Recently, particularly over the last month, the flatulence has reached an unbearable level, emitting an awful odor. This has led me to carefully monitor my diet; I am especially concerned about unexpected bathroom needs when at work, which makes eating a stressful experience. Could this possibly indicate celiac disease? Two decades ago, I participated in a forum associated with the Spondylitis Association of America, where discussions highlighted the potential role of gut bacteria in AS and its various symptoms. At one point, I also faced lactose intolerance which showed some improvement. Lately, however, I have been struggling with it again, limiting dairy intake significantly over the past five years. Although I have not adopted a gluten-free lifestyle—believing it to be unhealthy for the general population—I wonder if it might be necessary given my current condition. My weight gain concerns me, but I also feel as though my nutrient absorption is inadequate. My stool tends to be pale and fluffy, occasionally dark brown if digestion is slower. I’m uncertain if this communication will elicit any responses or insights, yet I’m reaching out in hopes of guidance that could facilitate a discussion with my healthcare providers. There’s a nagging sense that something isn’t functioning as it should. With my 61st birthday approaching, I sincerely wish to ensure my long-term health. If you’ve taken the time to read through this message, I truly appreciate it and would be grateful for any advice or experiences you might share.

Answers (1)

12/16/2025, 9:50:41 PM

OpenHealth AI

Thank you for sharing your detailed health history and concerns. It’s clear you’re facing a complex combination of issues, and I'm here to help address your immediate questions and provide guidance.

Main Points

1. Persistent gastrointestinal symptoms may suggest underlying issues worth investigating further.
2. Your concerns about celiac disease and nutrient absorption are valid given your symptoms.
3. Monitoring your diet and discussing potential dietary changes with your healthcare providers is essential.

Explanation

Given your history of gastrointestinal issues, it's understandable to question whether celiac disease or other conditions could be contributing to your symptoms like diarrhea, flatulence, and potential nutrient malabsorption. Celiac disease can present with various gastrointestinal symptoms, including diarrhea, bloating, and abdominal discomfort and is more common among individuals with certain autoimmune conditions.

Your prior experience with lactose intolerance also points to a sensitivity to certain food components, which can occasionally accompany other gastrointestinal disorders. We must remember that dietary changes can have a significant impact on your overall health and well-being, especially concerning conditions like IBS and AS.

Next Steps

1. Monitor Symptoms: Keep a food diary for at least two weeks, noting what you eat and any symptoms you experience. Pay attention to any correlations, especially with dairy and gluten-containing foods.

2. Trial Elimination: Consider a short-term elimination diet for gluten and dairy, under guidance from a nutritionist or your healthcare provider, to see if your symptoms improve. It’s crucial to ensure this is done correctly to avoid nutritional deficiencies.

3. Discuss with Healthcare Team: Share your observations with your healthcare team, particularly your primary care doctor and gastroenterologist. Discuss the possibility of testing for celiac disease (like a blood test for specific antibodies) and inflammatory bowel disease.

4. Nutrient Absorption Check: Since you mentioned concerns about nutrient absorption, ask your doctor about blood tests to check for deficiencies (like vitamin D, B12, folate, iron) which can offer insight into your nutritional status.

5. Consider a Lactose Breath Test: Since you’ve had past instances of lactose intolerance, a hydrogen breath test could help confirm this condition.

6. Stress Management: Given the association of stress with gastrointestinal issues, consider relaxation techniques (like mindfulness or yoga), which may help alleviate some symptoms.

Your desire to improve your health and manage your symptoms is commendable. While navigating through this can be challenging, approaching it step by step with careful monitoring and professional guidance can help provide clarity and relief. Please let me know if you need further details or support!