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Suffering with focal nodular hyperplasia. Get tingling in hands, diarrhea, extreme fatigue. Could it be stress?

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
I am a 38 year old white female. I have been experiencing a number of things which can be related or not related to one another at all. I have tingling painful numbness in both hands, diarehha most days, extreme fatigue ( I want to sleep all the time), and undigested food in my stool. I have no medical conditions other than focal nodular hyperplasia. I am concerned that something may be wrong or not at all. I do work a 3rd shift and I am a single mother of 4...ages 19, 16, 13, and 5. My 5 year old is Autistic. Could it be stress? I have a healthy appetite (eat like a horse). I am on the depo shot since 2008 and took me from then until XXXXXXX of 2012 to gain 30lbs on it but over the course of the last year I have dropped from 135 to almost 105. Any suggestions?
Posted Sat, 8 Jun 2013 in Brain and Spine
Answered by Dr. Mayank Bhargava 1 hour later
Welcome to XXXXXXX forum.

Let me know the associated symptoms along with mentioned.
Do you have acidic belching/ abdominal discomfort/ retrosternal burning pain/ abdominal bloating after taking meals?
Do you have fever/ spasmodic abdominal pain/ vomiting?
Do you have excessive flatulence/ gargling sound in abdomen?
Are you suffering from severe constipation previously?

With the available described symptoms, there could be possibility of small intestinal bacterial overgrowth/ small intestinal diarrhea/ acute viral gastroenteritis and dyselectrolytemia.
Other possibilities could be malabsorption syndrome as you are passing undigested food in watery shit.
As such there appears to be least correlation between present symptoms and depo preparation.

Whenever a patient comes with above mentioned symptoms, then generally 1st diagnosis is organic in nature. If condition won't improve with antibiotic then only non infectious cause should be suspected.
So stress should be suspected once all the organic causes has been ruled out.

You should consult with XXXXXXX medicine specialist/ gastroenterologist and should go for thorough check up.
You should go for complete blood count, erythrocyte sedimentation rate, ultrasound imaging, and serum electrolytes, renal function test.
You should also go for endoscopy with duodenal biopsy and urea breathe test (for helicobacter pylori) to rule out possibility of malabsorption syndrome.

Meanwhile, you should take complete antibiotic therapy, antispasmodics, probiotics, antipyretics, if needed.

You should maintain your hydration status by taking potassium XXXXXXX liquids.
Take soft diet along with yogurt and banana.
Avoid milk and all milk related products.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Suffering with focal nodular hyperplasia. Get tingling in hands, diarrhea, extreme fatigue. Could it be stress? 19 hours later
I do have bloating and excessive flatulence. The others do not apply. However I do experience cramping pain in my stomach before needing to use the bathroom and I have to go immediately. The diarehha does not occur at any particular time, more often than not it is several hours later after eating. If in fact it could be my small intestines could my liver be a factor in this as well? I am not sure if having FNH could cause my liver to not produce bile or not enough. The tumor that my liver has become (at last check) is 7.5 cm in diameter. I occassionally get a fever and pain where my liver is. This has been ongoing for several years. Should I consider getting it checked agian in relation to these issues I am having. I also am very concerned about the fatigue....I can sleep for a whole day and still be exhausted and wna to go back to sleep. I am ok as long as I am physically engaged in an activity (such as work).
Answered by Dr. Mayank Bhargava 59 minutes later
In my personal opinion, you are suffering from gastroenteritis and possibility of FNH induced appears to be low.
Immunocompromised state due to FNH may cause activation of opportunistic infection with diarrhea.
You should go for complete blood count, stool examination.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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