OpenHealth Q&A

Possible Inflammatory Bowel Disease

Subject: Potential Diagnosis of Inflammatory Bowel Disease In a recent health evaluation, I, a 19-year-old transgender male, who maintains an average weight, have been prescribed the following medications: - 100mg of lamotrigine - 60mg of duloxetine - Four pumps of testosterone gel - Four maltofer iron tablets **Medical Background:** My medical history includes several diagnoses: postural orthostatic tachycardia syndrome (POTS), a solitary kidney, iron deficiency anemia, gluten sensitivity, polycystic ovary syndrome (PCOS), and chronic low levels of vitamin D. Additionally, I have recently tested positive for antinuclear antibodies (ANA) while the celiac disease test indicated "leaning negative” results. Despite diligently taking oral iron supplements and making dietary changes, I continue to be severely deficient in both iron and ferritin. I recognize that my gastrointestinal health has been severely compromised, with persistent symptoms over the past several years, compounded by a history of mild issues during childhood. My general practitioner has suggested the possibility of autoimmune conditions due to my blood test results, but it seems that inflammatory bowel disease (IBD) is also a strong contender. I’m contemplating whether it is advisable to undergo testing specifically for IBD or other autoimmune disorders, given my symptoms. With the start of the academic year approaching, I find myself in urgent need of relief from this relentless pain. **For almost two years, I have been enduring the following symptoms:** - Persistent nausea and retching - Experiencing 4 to 7 days without bowel movements, despite attempts to alleviate this - Blood present in my stools and on toilet paper - Appearance of mucus and fat in stools - Episodes of diarrhea - An overwhelming, sudden urge to defecate - Once I begin, I struggle to stop until my bowel feels completely voided, often after several days - Anal fissures - Abdominal cramps and spasms - Intermittent loss of appetite - Instances of pre-syncope during bowel movements - The onset of hemorrhoids - Facial rashes that have recently calmed down - Ulcers in my mouth - Symptoms appear to fluctuate greatly in intensity - Periodic occurrences of jet-black stools **Attempts at Relief:** - Increased water intake - Electrolyte replenishment - Boosting fiber content in my diet with natural sources - Fiber supplements - Eliminating gluten, which improved blood presence and reduced severe constipation as well as mucus in stool - Utilizing heat packs - Taking 50mg of Coloxyl stool softeners (adhering strictly to guidelines for one week) - Engaging in walking, stretching, and yoga exercises *I understand that this may be too much information, but I do have photographs of stool samples if they are needed for further examination.*

Answers (1)

2/4/2026, 4:00:48 AM

OpenHealth AI

Given your ongoing gastrointestinal symptoms and complex medical history, it’s important to address these concerns thoughtfully. You rightly sense that something requires further exploration, particularly regarding inflammatory bowel disease (IBD) or other autoimmune conditions.

Key Points:

• Your symptoms, such as persistent nausea, altered bowel habits, presence of blood and mucus in stools, and abdominal pain, are concerning for potential IBD or other gastrointestinal disorders.
• Continuing to pursue proper testing and consultation with a healthcare provider is critical in achieving a diagnosis and finding relief.

Explanation:

You are experiencing a variety of troubling gastrointestinal symptoms, which could point toward conditions like IBD (Crohn's disease or ulcerative colitis) or another autoimmune issue. Your history of autoimmune markers (like positive ANA), iron deficiency, and symptoms like mucous in stools and anal fissures strengthen the need to investigate these possibilities further. Inflammatory bowel diseases cause chronic inflammation of the GI tract, leading to symptoms similar to what you're describing.

Next Steps:

1. Schedule Comprehensive Testing:

   • It’s advisable to request specific tests like a Gastrointestinal (GI) panel, stool tests to check for pathogens and inflammation markers, and imaging studies (ultrasound or perhaps a colonoscopy) to get a clear view of your condition.

2. Keep a Symptom Diary:

   • Track your symptoms including bowel movements, pain levels, dietary intakes, and any changes in your conditions. This can provide valuable insights for your healthcare team.

3. Dietary Considerations:

   • Continue avoiding gluten if it has been beneficial; consider working with a registered dietitian familiar with IBD to fine-tune your diet further. This can help manage symptoms and nutritional deficiencies (like iron and vitamin D).

4. Manage Symptoms at Home:

   • Continue with hydration, gentle exercise, and warm compresses for abdominal pain. You might also explore probiotics, which can support gut health (consult your provider before starting).

5. Mental Health Support:

   • With academic and personal pressures, consider speaking with a mental health professional about managing anxiety and stress related to your health conditions.

6. Regular Follow-Ups:

   • Ensure that you have regular follow-ups with your healthcare provider to monitor your condition and medication management.

Reassurance:

It's understandable to feel overwhelmed by your symptoms and the complexity of your health situation, especially with the impending academic year. Remember, pursuing clarity through testing is a positive step toward identifying effective treatments. Your attention to these symptoms signifies proactive self-care, and you're not alone in seeking relief. Please keep me updated on your situation.