Brief Answer:
About shingles:

Detailed Answer:
Hello XXXXXXX

I am so sorry you have shingles. I know all about shingles. Not just because I'm a doctor but because I had them too and learned a great deal from it (unfortunately).

It is hard to say definitively if your stomach problem is from shingles, but it could very well be.

Prior to the onset of the shingles eruption, many people experience a prodromal period. During this time, some get low grade fevers, generalized aching and transitory pains and loss of appetite. And at it's worst, people can get autonomic symptoms that affect their internal organs. I'll explain this: the shingles virus is from when you had chicken pox and it lives in an area of your nervous system (called the dorsal root ganglion). When, for whatever reason, your antibodies that keep it in check drop too low, the virus comes out and makes you feel sick. Then it goes to a skin area that is supplied by a particular nerve group and causes eruptions in that area. But the internal organs associated with that region can also be affected (temporarily).

Once you have been on the antiviral medicine for a few days, the internal organ symptoms should resolve. That does not mean the trouble is over yet as the shingles lesions will continue to erupt for awhile. But soon your body will get it in check and you will recover.

So I am assuming that you are now on Acyclovir or Vancyclovir. If your stomach symptoms do not start to resolve in the next 2-3 days, then most likely your stomach symptoms are not from the shingles.

May I ask, are your shingles eruptions on your abdomen or back? Because I think it would be less likely for your stomach symptoms to be from shingles if, say, your eruptions were coming out on your neck or face.

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Brief Answer:
Evaluation for autoimmune disorder

Detailed Answer:
Hi XXXXXXX

Three months would be a long time for a prodromal period for shingles. But it may be possible as your skin symptoms sound consistent with shingles.

An autoimmune work up usually starts with your primary care doctor who should do a thorough physical exam, a CBC with Differential, and urinalysis, and also draw labs for ANA (antinuclear antibody), RF (rheumatoid factor), and ESR (also call sedimentation rate). The thing is, right now your ESR will be high because of the obvious inflammation you are having - it is a nonspecific test for inflammation. And the CBC may look off from your body fighting a virus.

These tests are usually the starting place for an autoimmune evaluation, but other specific tests will be ordered depending on the areas you are having problems with and what symptoms you are having. And depending on the physical exam and the initial lab tests, your doctor may send you to a rheumatologist for further evaluation and treatment.

Given that you have been having abdominal cramping, it would be good to get a blood test for Celiac disease, too.

And, if the abdominal symptoms continue, please follow up with your doctor. A physical exam of the abdomen can give some information about where the pain may be coming from, and if it is the stomach area, an acid blocker like Zantac 150 mg might help. And there are antispasmodic medications too. An ultrasound of the abdomen can provide information and is noninvasive. If these don't help sort out the stomach problem, your doctor may want you to see a gastroenterologist for an endoscopy of your stomach.

But about shingles: the generalized sickness seems to go away in a few days from when the shingles erupts. If you are not getting much worse with your generalized symptoms (other than more eruptions may come out), I'd give this a little time now. But if your stomach symptoms or joint aching (i.e. pain other than the nasty shingles pain) is getting worse, then do go back in to be seen.

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