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Abdominal pain and sensitivity. Blood in stool, rashes, GERD, heart burns. Investigate further?

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Gastroenterologist, Surgical
Practicing since : 1984
Answered : 922 Questions
My son is 25 & for the past 3 years experiences severe abdominal pain on the left side & sensitive to touch. He cant sleep, has no energy, always complaining of his side hurting. He has at times loose blood separated from stool, very painful going to the bathroom to the point of crying. Over the last year developed itchy red rashes nearly every day after showering with no change in shower products. He gets headaches, has extreme anxiety & is extremely irritable. Irritability has been going on for years. Diagnosed in early teens as ADD, had severe reaction to milk products as a baby (I put him on soy), though he doesn't complain of lactose intolerance now). and remained in hospital when born in an incubator for severe jaundice. He had an upper & lower GI, diagnosed with GERD (always complained of heartburn), and from what i can remember of the test results (they were never explained to us, as the physician was very disgruntled by the my sons revealing he smokes marijuana on a regular basis (he has a medical certificate to do so), and simply stated he was a drug addict. Son says it helps with pain & anxiety (not sure I buy into this but I do know he has been in chronic pain for nearly 3 years). I believe the tests also showed intestinal inflammation & some narrowing, possibly some ulcers. A few days ago i came across information on celiac's disease & intolerance to gluten. My research shows many similarities to this disease. His family history is strong in gastrointestinal diagnosis, that include food allergies, IBS, Chrons disease, GERD, pre-cancerous esophagus conditions, chronic stomach issues, hital hernia repair, chronic fatigue. In your opinion, could his symptoms warrant further investigation of celiacs disease or gluten intolerance? I asked him to start keeping a diary of how he felt compared to what he ears. As a young adult with a limited income (and no health insurance - I usually have to pay out of pocket to help but so many doctors & no diagnoses is very expensive), he eats a lot of food with gluten such as pasta, cereal, bread, fast He said he had eaten a lot of pasta recently and experience increased pain during that period of time. Am I barking up the wrong tree? I hate to see him in so much pain & at times his irritability is too much to handle to the point of wanting to avoid conversation - I just want to help get this figured out so he can get on with his life.

Thank you,
Posted Thu, 19 Apr 2012 in Digestion and Bowels
Answered by Dr. Ajit Naniksingh Kukreja 8 hours later

Thanks for posting your query

Its appreciable you have been caring for him in adverse situations

What I gather from your history is :

He has symptoms of inflammatory bowel disease
He has symptoms of GERD
He is addicted to Marijuana
He had lactose intolerance/has gluten intolerance and
He is irritable, rather suffering from anxiety disorder

Taking care of this patient medically also needs patience and a systematic approach
No you are not barking at the wrong tree but we need to rule out Celiac disease in a proper differential diagnosis

What is the consistency of his stools? Does he pass foul smelling and fatty stools?

DO you have any blood reports done?

Do you have any Endoscopy reports to share?-as you have mentioned of some ulcers and narrowing ?

Was any biopsy taken from the ulcer or the stricture?

If yes revery back to me with the reports and we will help you sort out the issue

Or else he needs some laboratory investigations and also

He needs to undergo a Upper GI & Lower GI endoscopy with biopsy from whatever suspicious area seen,if the blood reports are normal

He has GERD, and most symptoms do point out to Gluten Intolerance, though the prevalence in males is lower than in females, also this is common in patients of European and caucasian origin, but he has a strong family history [ A biopsy from duodenum will help come to a diagnosis of Celiac Disease]-

I would like to rule out ulcerative collitis and crohn's disease also

Another issue that needs to be taken care of is Marijuana addictions

Hope all clear, Get back to me with the data asked and we will help you out

Wishing your son a speedy recovery
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