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Suggest Treatment For Exhaustion, Headaches And Pain In The Abdomen

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Posted on Mon, 16 Jan 2017
Question: Hi I'm 54 year old female who has had an upper Ct and colonoscopy. I have now undergone a capsule endoscopic procedure. The camera went through me in 4 hours. I am awaiting tests for what I don't know? Maybe a slow bleed? I am very anemic. I have had two rounds of infusions by a hematologist, so far my reticulocyte count was 12090. Lymph 48.4. Neut 75.7 RBC 3.88 RDW-SD 49.7, my RBC count did respond to normal- just borderline - and I will return in two weeks.
I also have macrocyctic anemia as my MCH is 35.6 and my MCV is 101.9. I receive B-12 by injection at this time also. I had a quantative test for malabsorption but it was normal. Can you help? I'm exhahauted, diahrea, dizzy, headaches, cold, painful abdomen
Thank you
XXXX
YYYY@YYYY

I'm sorry I forgot to say I have lost 25-30 pounds thank you again
doctor
Answered by Dr. Shoaib Khan (4 hours later)
Brief Answer:
Please read below about irritable bowel syndrome, etc.

Detailed Answer:
Hello and welcome to HCM.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. Based on your brief history, a bleed should be ruled out, and a capsule endoscopic procedure should help.

A more simple procedure called 'stool for occult blood' would also be helpful, although not always accurate, if repeated 2-3 times, it does help in providing information on possible bleeds.

But changing the perspective here for just a minute, I would also light to pay a little emphasis to certain intestinal conditions that can present with most of your symptoms, like irritable bowel syndrome or inflammatory bowel disease (to name a few).

Both these conditions present with symptoms like:

+Diarrhea
+Abdominal boating
+Increased urge to pass your bowels soon after consuming certain types of food or drink
+Sometimes bleeding
+Mal-absorption
+Weight loss (not always, but can be seen especially due to a diet rich in trigger foods or drink)
+Nutritional deficiencies (mainly due to absorption issues as the intestine can be inflamed; specific deficiencies seen are with iron, folate, bile salts and vitamin B-12) and a few others.

In such a scenario, clinical presentation and patient history play important roles. If you have experienced an increased urge to pass your bowels after eating certain meals then we should suspect such conditions. If you experience symptoms like mucus with stools, difficulty with tolerating specific types of foods (e.g. caffeine, fried food, fatty food, certain types of fruits and/or vegetables, etc.); diarrhoea in response to food, stress, etc.

So, in order to have a more broad spectrum I would request you to discuss such a perspective and go ahead with a few blood investigations like ESR, p-ANCA, c-ANCA, etc.

I hope you find my response helpful and informative. Please feel free to write back to me for any further information or clarifications, I am always here to help.

Best wishes.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Shoaib Khan (22 minutes later)
Thank you very much and I know it is hard to answer these questions on-line. I did already have those tests and they came back negative along with celiac disease. As this has progressed now to anemia, my bone marrow test show a value of 0 iron and an iron panel showed a value of 24. I was started on infusions. I believe that was the reason for the capsule endoscopy, to investigate for a slow bleed? I'm still nervous as my oncologist/hematologist has spoken of cancer but no results of that yet. Do you have any other information? The waiting is very scary. Thank you again
XXXX
doctor
Answered by Dr. Shoaib Khan (21 minutes later)
Brief Answer:
A little information, not much while we await the results

Detailed Answer:
Hello once again XXXX.

I am glad those conditions were ruled out, and yes of course, I completely understand how the wait can be, it is rather torturous.

Information wise, my job is to make sure you are being well investigated in order to reach a more accurate diagnosis. And it does seem like your doctors are taking the right path, the extreme weight loss does raise suspicion for cancer, but I am sure we can soon rule it out with your doctors help.

If a bleed is found, then we should be able to help you better, so the results should soon provide you with relief (hoping and praying it isn't cancer). I would also like to ask if a PET scan was conducted (although a little on the pricey side, it can provide us information on the cancer location and its progression, if present, which can save us time and energy).

Anemia can also be related to a woman's menstrual cycle, but I am sure that must have been one of the first few conditions ruled out, just making sure it was.

A painful abdomen does point towards an issue with the GIT, mainly with ulcers or colon cancer (CEA and/or CA125 are markers used to confirm/rule out colon cancer and should be checked while we wait for the capsule endoscopy results).

Unfortunately, for now all we can do is wait for the results, and hope and pray (as I am also doing) for the best. Please do not hesitate at any point to write to me, even if it is for the simplest of clarifications, I am here to help and shall do so to my best.

Best wishes.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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Suggest Treatment For Exhaustion, Headaches And Pain In The Abdomen

Brief Answer: Please read below about irritable bowel syndrome, etc. Detailed Answer: Hello and welcome to HCM. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. Based on your brief history, a bleed should be ruled out, and a capsule endoscopic procedure should help. A more simple procedure called 'stool for occult blood' would also be helpful, although not always accurate, if repeated 2-3 times, it does help in providing information on possible bleeds. But changing the perspective here for just a minute, I would also light to pay a little emphasis to certain intestinal conditions that can present with most of your symptoms, like irritable bowel syndrome or inflammatory bowel disease (to name a few). Both these conditions present with symptoms like: +Diarrhea +Abdominal boating +Increased urge to pass your bowels soon after consuming certain types of food or drink +Sometimes bleeding +Mal-absorption +Weight loss (not always, but can be seen especially due to a diet rich in trigger foods or drink) +Nutritional deficiencies (mainly due to absorption issues as the intestine can be inflamed; specific deficiencies seen are with iron, folate, bile salts and vitamin B-12) and a few others. In such a scenario, clinical presentation and patient history play important roles. If you have experienced an increased urge to pass your bowels after eating certain meals then we should suspect such conditions. If you experience symptoms like mucus with stools, difficulty with tolerating specific types of foods (e.g. caffeine, fried food, fatty food, certain types of fruits and/or vegetables, etc.); diarrhoea in response to food, stress, etc. So, in order to have a more broad spectrum I would request you to discuss such a perspective and go ahead with a few blood investigations like ESR, p-ANCA, c-ANCA, etc. I hope you find my response helpful and informative. Please feel free to write back to me for any further information or clarifications, I am always here to help. Best wishes.