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Diagnosed with POTS. Done with CT for abdomen, pelvis. SGOT normal. Having stress, losing weight. Cure?

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Gastroenterologist, Surgical
Practicing since : 1984
Answered : 913 Questions
Hi. I am a 26 Year old female who has had major health issues since November 2012. Was diagnosed with POTS syndrome (autonomic nervous system and it can affect anythnig thats "Autonomic" in the body . At the eEXACT same time my POTS started I started to have very bad irregular bowel movements. MY stools are now yellow - I had a fat stool test showed fat malabsorbtion. But we cannot find the cause. I am a nurse so I understand SOME medical things. THis is the testing done so far for the bowel issue. I had a colonscopy that showed "Terminal illium- there was a moderate amount of eyrthema and granularity in terminal illium, biopsies obtained" - "Cold biopsies" done and stated "Terminal illium biopsies :Terminal ilium with congestion and edema. a few benign lymphoid aggregates noted. Negetive for acute inflammation , granuloma or dysplasia. 2 random biopsies-colonic mucosa with congestion and edema, negetive for inflammatory bowel disease or microscopic colotis" also showed XXXXXXX hemmroids. THEN I had an EGD- EGD showed gastritis and nothing else. I followed up then with a HIDA scan it was normal it said "Normal hepatobililary scan with normal gallbladder ejection fraction of 47%" I also had a RUQ ultrasound it showed "Liver is unremarkable in contour shape and parenchymal echogenicity. There is no evidence of intra or extra hepatic bililary dilation with the CBD measuring up to 2mm. Gall bladder is on remarkable with no evidence of choleithisasis. THe visualized portion on the pancreas is unremarkable wiht the body and tail not well visualized due to overlying bowel gas. Screening images of the right kidney demonstrate no XXXXXXX hydronephrosis and unremarkable cortical echogenicity. The right Kidney measures 10.8cm in length Impression- Unremarkable RUQ ultrasound.

THEN I had A CT Abdomen/Pelvis done- said this "Lung bases are clear, the liver, spleen, gallbladder, pancreas, kidneys, and adrenal glands are within normal limits. A small splenule is noted anterior to the spleen. No mass or adenopathy seen. Now bowel wall thickening, edema, pneumoperitneum or acites is evident- the uterus and adnexa are unremarkable No osseous lesion seen- NEgetive

stool samples YAY- occult blood- Negetive recently but before the colonoscopy in november i had it Positive x 3
Ova/Parasites- Negetive.
Cryptosporidium antigen- Negetive
Giardia antigen- negetive
Amylace- 45
lipase- 115

SGOT- normal
I have had MANY CMP's , CBC's all normal
CPK 0.1
Celiec disease tested by blood and biopsy- negetive
CT angiogram- negetive ( I Know that has probably nothing to do with it)

anyway end story is this---- what else could be causing THIS? can the POTS (autonomic dysfuction) make this happen? doc is clue less- he wants to redo the colonoscopy- because that was done by a DIFFERENT doctor.

I have been under MAJOR stress since November- All of this started after the preterm delivery of my baby who died October 31st, 2 weeks later the bowel and Autonomic Dysfuction started.
I have lost since november (now April 2) I have lost 19 lbs and down to 130lb. I never smoke - occasional wine- no tobacco - no illicent drugs no nothing
Prior to pregnancy- Healthy
Posted Sun, 21 Apr 2013 in Hypertension and Heart Disease
Answered by Dr. Ajit Naniksingh Kukreja 1 hour later

Thanks for writing in

I can very well understand your concern, but you being a nurse my first word will be a word of reassurance

What I gather from your information is that there is lot of stress after the preterm labor and loss of your child.....

You would be aware stress is associated with GI Symptoms known as blood can be due to hemorrhoids and that is always common during pregnancy

I would suggest you add a good probiotic to your daily routine twice a day for a minimum of two weeks, followed by another two weeks of maintenance once a day

Manage your stress levels and all should be OK

Hope this helps
Do write back in case of concern
Wishing you a healthy life ahead
Above answer was peer-reviewed by
Follow-up: Diagnosed with POTS. Done with CT for abdomen, pelvis. SGOT normal. Having stress, losing weight. Cure? 8 minutes later
can the stress lead to fat malabsorption- that was the only found + test? and I know POTs and any dysautomias can cause malfunctions in the gut. I had an XXXXXXX 1:80 speckeled. . . thats when I got extremely nervous- because fat malabsorption and on a rheumo thought could be sclerederma- though i have no skin issues raynaurds syndrome . after i eat usually my stomach gurgles like crazy - then i feel hungry again 20 minutes later. I am currently on Creon (doc thought that would help) and pre/probiotics.

Yes my stress has been High- extremely. i get sick easily from it, I cry every day. i put myself in a depression due to health- (not suicidal dont worry there) and this stress - has been going on since november which amazingly has been 5 months now.

as a nurse- i look for my own answers- which isnt helping matters :-( .. dr google that is.
Answered by Dr. Ajit Naniksingh Kukreja 18 minutes later

Thanks for your followup query

One thing I would suggest is do not rely on all that is available on the web

Again when I get sick I approach a doctor as a lay person - because self medications has always led to stress - we [medics and paramedics] start assuming the worst for ourselves as patients

Now to your queries :

Yes stress can cause fat malabsorption

Regarding XXXXXXX - the XXXXXXX test very sensitive for the diagnosis of autoimmune diseases but can result in many false positives. At a dilution of 1:160, only 5 percent of normal individuals have a positive test for XXXXXXX

You may see a good rheumatologist and get your self clinically examined if concerned but do not stamp anything by yourself

Hope I have been able to clarify your doubts
Do not hesitate to write back
Wishing you a very healthy life ahead
Above answer was peer-reviewed by
Follow-up: Diagnosed with POTS. Done with CT for abdomen, pelvis. SGOT normal. Having stress, losing weight. Cure? 26 minutes later
Just out of curiousity have you heard of POTS syndrome (postural orthostatic tachycardia syndrome) not many have.
Answered by Dr. Ajit Naniksingh Kukreja 9 minutes later
Hi Again

Yes though not very common I am aware of this syndrome, but frankly speaking the pathophysiology of the same is not very clear

There is some known relationship of the syndrome with Chronic fatigue syndrome but any way that would be more confusing and my suggestion would be - let the expert in the industry manage it

Hope this clears your doubts
Wishing you a very speedy recovery
Above answer was peer-reviewed by
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