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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Episodes Of Vomiting,abdominal Bloating And Diarrhea?

For several months, I have had intermittent (once very few weeks or months) bouts of simultaneous vomiting and diarrhea. It starts with abdominal bloating and gas, and then the abdominal pain becomes more severe. After that, the palms of my hands and soles of my feet become itchy, red, and blotchy.Then, I start to vomit and have explosive diarrhea uncontrollably. Nothing in my diet or routine has changed, nor have any products that I use differed. I have seen my primary care physician and a Gastroenterologist. A colonoscopy revealed a small irritation in my intestinal track near my appendix, but nobody was able to determine a cause or a course of treatment. In addition, my father and other family members on his side of the family suffer from Crohn s Disease. I have never had any symptoms myself.
Tue, 2 Jan 2018
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General Surgeon 's  Response
Hi.
Thanks for your query.
Noted the history and understood the concerns.
Since your Parents have known Crohn's disease, there is a chance that the redness in colon near appendix on colonoscopy is suggestive of Crohn's or so like tuberculosis or any other granulomatous disease. Hence I would advise you the following in such a situation:
Repeat colonoscopy and insist for biopsy as the result of biopsy is the only thing that is confirmatory.
The bouts of bloating followed by vomiting and explosive diarrhea once in a month or so wherein you have not changed your diet can also be due to the following things:
Granulomatous diseases as mentioned above.
IBS that is irritable bowel syndrome that is related to the stress and anxiety and wherein all the relevant investigations as mentioned below will be normal. CT scan of abdomen, tests of stool, blood and urine; colonoscopy and any other as required.
A course of an antibiotic, metronidazole and probiotics may solve your problems.
Although the colonoscopy is normal, the palms and soles getting itchy, red and blotchy indicate towards intestinal infection as a probable cause or Carcinoid syndrome in rare cases which need special blood and urine tests along with CT scan of the whole abdomen.
All these factors will lead to a probable diagnosis and thus to a proper management.
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What Causes Episodes Of Vomiting,abdominal Bloating And Diarrhea?

Hi. Thanks for your query. Noted the history and understood the concerns. Since your Parents have known Crohn s disease, there is a chance that the redness in colon near appendix on colonoscopy is suggestive of Crohn s or so like tuberculosis or any other granulomatous disease. Hence I would advise you the following in such a situation: Repeat colonoscopy and insist for biopsy as the result of biopsy is the only thing that is confirmatory. The bouts of bloating followed by vomiting and explosive diarrhea once in a month or so wherein you have not changed your diet can also be due to the following things: Granulomatous diseases as mentioned above. IBS that is irritable bowel syndrome that is related to the stress and anxiety and wherein all the relevant investigations as mentioned below will be normal. CT scan of abdomen, tests of stool, blood and urine; colonoscopy and any other as required. A course of an antibiotic, metronidazole and probiotics may solve your problems. Although the colonoscopy is normal, the palms and soles getting itchy, red and blotchy indicate towards intestinal infection as a probable cause or Carcinoid syndrome in rare cases which need special blood and urine tests along with CT scan of the whole abdomen. All these factors will lead to a probable diagnosis and thus to a proper management.