Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

178 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Have arthritis. Had gout attacks. Tested negative for auto immune disorder. Suggestion?

Answered by
Dr.
Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

default
Posted on Thu, 27 Dec 2012 in Digestion and Bowels
Question: I am 31,white male, 6'3", 230 lbs. Starting about a year and a half ago I started developing arthritis in my fingers. I had previously had and still have gout attacks so I was under the impression that it was related to that. The arthritis remained and eventually intensified and spread to my wrists and further to just about all of my joints. I have tested negative for rheumatoid arthritis and autoimmune disorders and my CBC has come back normal, minus the high uric acid. I also tested normal for kidney function. In addition to the arthritis I have bowel problems, constipation and when I do have a movement its often watery and thin. It should also be noted that I have had an inguinal hernia for about the past 5 years. In addition to the others symptoms noted, I also have what appears to be a ganglion cyst on the top of both hands near the wrist, moderate to severe fatigue and as noted earlier I'm very susceptible to gout attacks. I suppose it should also be mentioned that when I urinate in the mornings I sometimes get severely fatigued to where my heart is beating faster and I feel as if I might pass out. I get the same feeling when I take a long hot shower. Lastly, within the last three or four years I get cold easier, I first attributed this to weight loss (about five years ago I lost around 100 lbs) but thought I'd mention it. I have an appointment set up with a rheumatologist in late December although I don't know if I'd be better served going to an gastroenterologist or someone else. Any advise or help will be greatly appreciated. Thanks
doctor
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXXXX
You certainly seem to have multiple problems.
You said that tests for autoimmune disorders
were negative. I assume they have ruled out
systemic lupus which can affect multiple organs
including skin,joints,kidneys,liver and blood vessels.
I see that your kidney function tests were reportedly
normal.
The two medications that you are taking do have
side effects. Uloric which helps to block the build up
of uric acid in the blood can cause skin rash, nausea
along with some other side effects. A drug similar to it
that was being used was Allopurinol. We did see cases
of diarrhea from that. It is possible Uloric may also do the
same.
The other drug Mobic (Melaxicam) can cause heart problems
because of it's effect on the blood clotting factors, platelets.
Also stroke has been associated with this. Most of the side
effect on the intestinal tract is serious bleeding or perforation.
It is highly advisable not to drink alcohol with this medicine.
Gouty arthritis is associated with nodules (Tophi) over the
knuckles or side and top of toes. These contain crystals of
uric acid if removed and examined.
Constipation could be due to lack of adequte fiber intake.
Feeling of fatigue and the heart beating a little faster may
be indicative of low blood count. If you have not had a recent
complete blood count, get that done. Also make sure your stool
is tested for hidden blood to rule out any bleeding from the
intestinal tract.
Start taking some fiber supplements such as metamucil 1-3
tablespoons a day mixed with water daily.
After your visit with your Rheumatologist you will be able to
determine if you need additional testing.
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Charles S Narasi 19 hours later
Thank you for your insight. One other thing i forgot to mention was changes in my finger nails. My nails have developed verticle ridges...this came about around the same time as the arthritis.
doctor
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXXXX
You are welcome. As for the ridges in the nail, it
might indicate vit. deficiency like calcium,vit-A.
Sometimes we see that in Anemia as well.
That's why it is important to have your blood count
done.
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Drug/Medication
Medical Topics ,  

Recent questions on  Diarrhea

doctor1 MD

I have had diarrhea for about a year. I have been tested for everything and w/ no clear diagnoses except overgrowth of bacteria in the small intestine. I have been told that I am not a candidate for fecal transplant but I am interested as others have asked me why I have not persued that treatment plan. What are my options?

doctor1 MD

I just notice outside of my anus right side a flesh bump no pain no blood little large and hard just finished eating spegettie clam sauce, and fresh natural pineapple,.also had 2- large and hard stool movements today same time one after the other, 1-hr later diarrhea.

doctor1 MD

Hello. My husband, son and I all ate fish from a fast food restaurant on Thursday. On Friday, I had diarrhea over the course of the day with some abdominal pain, weakness and fatigue. I felt better by that evening. My son was a little nauseous on Friday night, but felt better with Pepto Bismol and tums. My husband became feverish with chills, severe weakness, and severe diarrhea on Friday evening. He has continued to feel weak since then with diarrhea and some nausea. He has no appetite. I have been offering crackers, soup, ginger ale, and popsicles. He is very tired and has been sleeping most of 2 + days. He does not think he needs to see the Dr. ..... He is diabetic (oral meds) and is being treated with hormones for prostate cancer. Thank you for your help.

doctor1 MD

my husband has had chronic diarrhoea since christmas 2013 he went to the doctors a few weeks ago and was told to take a stool sample in to the doctors and to starve for 24 hours, he did this and he rang the surgery a week later to get the results and was told the stool sample was normal, well he is still having chronic diarrhoea what should he do

doctor1 MD

For 3 yrs. I have been passing odd things in my stool.Started with gravelly looking layers in my stool.Passed a yellow thing with some hair and black shiny square like tar. It was sticky.After a while ,quit passing those odd things and started...

doctor1 MD

I HAVE BEEN HAVING SEVERE CRAMPS/SHARP PAINS IN MY PELVIS FOR THE LAST 2 DAYS. IT IS SPORADIC BUT VERY UNCOMFORTABLE WHEN IT OCCURS. I CANT PINPOINT ANYTHING THAT I HAVE EATEN OR DONE THAT WOULD CONTRIBUTE TO THE ISSUE. I HAVE ALSO EXPERIENCED A...

doctor1 MD

Have soreness/tenderness on both sides of head, fever between 99.9 and 102.5. Nauseous! sore joints.