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Nausea,green smelly bowels,loss of appetite,sweaty nights,gurgling stomach,gas,weight loss,acid reflux,prilosec,

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I have had abdominal issues over the last 3 weeks. I have been experiencing nausea, XXXXXXX bowels (greenish hue) 95% of the time (non-diareaha), lack of appetite, nite sweats, gurgling stomach, gas, weight loss. there are times during day i feel ok, others that have just a general sense of not feeling well (more so in morning). The bowel movements have a distinct smell from a normal bowel movement. Initially thought i was viral but has gone on too long. Went to dr multiple times over last couple weeks and have had an upper gi done..showed nothing but some acid reflux (thus put me on the prilosec). Stool has tested negative for blood. Ultrasound of every organ in the abdomen was normal. am currently waiting on results from stool culture test for parasites. also, doctor ran blood tests and everything was normal..counts, hplyori, etc..Wondering what this could be. Any thoughts would be appreciated. I have an appt w/ a gastro doc coming up next week.
Posted Wed, 2 May 2012 in Digestion and Bowels
Answered by Dr. Robert Galamaga 2 hours later
Hi XXXXXXX and thank you for your query.

Let me first state that abdominal symptoms can be sometimes difficult to categorize as far as a pure cause goes but we can consider what might be contributing to this and go from there. I am sure you have answered many questions asked by your own personal physicians and I apologize if some of the questions I ask are redundant.

You provide a history of weight loss, irregular bowel symptoms with the bloating/gas/and greenish-hued bowel movements. I have to consider the pancreas in this case which is the manufacturing center of many digestive enzymes. If there is malfunction of the pancreas it can create alot of diverse symptom such as change in stool color or consistency, pain and even weight loss. I am curious to know what blood tests your doctor did run and if you have a copy of them you could forward those to my attention at YYYY@YYYY . Has your doctor considered doing endoscopy where he will be able to look in your esophagus and in your colon for any abnormality? I suspect that will be what the gastro doc may recommend.

Has there been any change in your diet at all or do certain foods correlate with your symptoms such as milk or dairy products? Lactose intolerance can create bloating and changes in stool etc but is not notorious for causing weight loss. Finally, gluten allergy or insensitivity may cause these symptoms as well. This can be checked for with blood tests and/or a biopsy of part of the intestines that can be done during an endoscopy.
XXXXXXX there is so much to consider when discussing abdominal symptoms and I hope I have shed some more light on what you are trying to understand here. You will certainly get to the bottom of this with the gastro doc I am sure. I am available for your followups and for sharing the lab data if you have that available.

Best regards,

Dr. Robert Galamaga
Above answer was peer-reviewed by
Follow-up: Nausea,green smelly bowels,loss of appetite,sweaty nights,gurgling stomach,gas,weight loss,acid reflux,prilosec, 1 hour later
Thanks for the response. I will have to contact the doc to get the exact blood tests so i may not have today. i know they ran blood counts, liver function, hplyori..but not exactly sure on the others. regarding the pancreas. Would something would have been seen on the ultrasound of the abdomen if it were the pancreas? When you mention "pancreas malfunction" what type of things could be wrong? My mother has had diverticulitis..would any of my symptoms point toward that? finally, what are your thoughts on this being a potential parasite?
Answered by Dr. Robert Galamaga 6 hours later
Hi there and thanks for your followup.

Regarding pancreas dysfunction I am referring to a disruption in the normal production and secretion of digestive enzymes produced by the pancreas. This can happen from an inflammatory or immune process or sometimes can be related to diet - such as a very high fat diet or from excess alcohol intake.

The ultrasound might show such things as calcium deposits or abnormal cysts in the pancreas but the ultrasound does not show how well the pancreas is functioning. This does not sound like classic diverticultis as you would probably have much more pain if it were that. The gastro doc can also rule that out with a colonoscopy.

A parasite would be quite a rare cause of what you have going on especially in the absence of high risk exposure such as travel to am area of the world where parasites are endemic.

Where was your blood clot found? Did they attribute the clot to an injury? I imagine you were screened for coagulation disorders at that time as well?

Thanks again for your query. I am available again for followup if needed.

Thank you.

Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Nausea,green smelly bowels,loss of appetite,sweaty nights,gurgling stomach,gas,weight loss,acid reflux,prilosec, 9 hours later
i guess i am panicking about this being some type of cancer. i have no history of colon, pancreatic, or intestinal cancer in my family. would something have shown up in blood counts or ultrasound of abdomen (tumors) if that were the case? Regarding your comment on alcohol, i have never drank and have never smoked. I work out 4-5 days per week and am in good physical condition and have made it a point to eat right.

If this is some type of pancreas malfunction (ie inflammation) how is that treated?

regarding the blood clot, it was located in my left calf, behind the knee. they have done multiple clotting factor tests at the time of, 6 months later and 1 yr later and nothing has come up. The clot was not attributed to any particular injury.

thanks again for your response.

Answered by Dr. Robert Galamaga 6 hours later
Hi XXXXXXX thanks again for your followup.

I think sometimes it is a human nature to assume the worst when trying to figure out why our bodies are not acting quite right. As far as cancer goes - this is unlikely - statistically - and will be eventually ruled out as you continue your workup.

Regarding the pancreas, if there is some limited fucntion, sometimes we treat patients with medications such as prescription enzyme supplements or anti-inflammatory medication if there is an autoimmune process going on.

It really sounds like you are taking care of your body - better than most people actually! I have to urge you to maintain a healthy and positive attitude as I believe in the mind-body connection very strongly and believe me, I wish I could hand you a diagnosis and recommend treatment right now but the additional workup needs to be done. You will be in the hands of a trained specialist with the gastro doc and I am confident that a physician with fellowship training in gastroenterology will hold the ultimate key in getting to the bottom of this.
XXXXXXX I thank you once again for your query and please keep some of the considerations we have exchanged with you and discuss them with the gastroenterologist. I wish you continued optimal health as well.


Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Nausea,green smelly bowels,loss of appetite,sweaty nights,gurgling stomach,gas,weight loss,acid reflux,prilosec, 23 hours later
Whatever is going on with me seems to be somewhat intermittent. Meaning, i feel ok at times during day and others i'm experiencing the symptoms more (ie nausea, sour stomach, growling stomach, etc).

1) The symptoms appear to be more apparent in the am hours, and by the end of the day i tend to feel somewhat ok (comparatively speaking). Does this tell you anything?

2) Also, given the fact that the symptoms have remained exactly the same over 3 weeks (nausea, stomach gurgling, light XXXXXXX hued bowel movements 95% of the time) without getting better or worse, does that say anything as well?

3) My weight also continues to decrease despite me still eating. I have lost approx. 10lbs. Im sure some of this is me not eating as much, however i am still eating and at times quite a bit to get the calories in so as to not continue to lose. Could an enzyme issue (like you mentioned before) do something like this?

Thanks again for your follow-up.
Answered by Dr. Robert Galamaga 5 hours later
Hello again XXXXXXX

I would honestly be speculating in trying to categorize your symptoms into a narrowed diagnosis. I have to wonder also if there is an element of baseline stress/anxiety at play here. I am by no means suggesting this is "in your head" - I am rather emphasizing the strong mind body connection. I have had several patients who during a personal struggle with stress or anxiety or depression have experienced weight loss and multiple gastrointestinal symptoms such as bloating and weight loss as well as change in stool caliber, color and consistency.

An enzyme issue could contribute to these symptoms but that is only one among the many considerations we have to entertain. The duration of your symptoms - more acute than chronic - does not necessarily help us much in the absence of colonoscopy, esophagogastroduodenoscopy (EGD) or perhaps imaging such as a CT scan or additional lab studies which I indicated in a previous reply.

If I can urge anything at this point it would be for you to try to remain calm, continue your normal daily routines, eat a well balanced diet and followup with your specialist. Again, I wish I could provide you with a more clear answer or even a solution at this point but it is unfortunately not possible. I hope, however, that I have helped you more clearly understand the considerations that we as physicians keep in mind in working on addressing the problem, identifying a cause and working on a solution.

I again wish you all the best.


Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Nausea,green smelly bowels,loss of appetite,sweaty nights,gurgling stomach,gas,weight loss,acid reflux,prilosec, 1 hour later
Thanks so much. The symptoms are definitely there, but you may be right to some extent as i tend to be more of a worrier than i have in the past. I lost my step-father in 2004 due to stroke and just lost my brother in October 2010 due to cardiac arrest (related to weight - 350lbs/diet/smoking, srtress/lifestyle etc/..)..So with any little health issue i may be a bit more "sensitive" than others..I hope to get some answers this week as I XXXXXXX with gastro doc.

I appreciate all of your feedback.
Answered by Dr. Robert Galamaga 2 hours later
XXXXXXX it has been my pleasure.

Thank you for allowing me to provide you feedback regarding your health. I wish you all the best and a continued road to better health in the future.

Dr. Galamaga
Above answer was peer-reviewed by
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