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Doctors Lounge - Gastroenterology Answers
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| egentile
- Tue Dec 05, 2006 4:08 pm |
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Hi,
I am a 35 year old female who began experiencing left sided pain last May in lower left abdomen and back. Went to the doc and they thought maybe I had an ovarian cyst - went for the GYN work up but nothing was found. The pain continued until it blew up in July - had an emergency endoscopy. GI doc found that I have a hiatal hernia, severe gastritis and 7 gastric ulcers. He put me on achiphex at that time and told me I needed time to heal. During this healing time I became worse and worse, started having bloody mucous filled bowel movement. I then had a colonoscopy and GI doc told that I had ulcerative colitis. My colitis during this whole episode of illness has been mainly associated with constipation (with very small intermittent bouts of diarrhea). He then put me on Pentasa to help with the inflammation. During this time I have lost over 25 lbs. I continue to lose the weight. More recently, I have been having bouts of left arm swelling and left calf swelling and heart palpitations - these are all associated with bowel movements. Almost like I have a little episode before a bowel movement. I also have left sided numbness and tingling when I have these attacks which come and go. I am concerned about malabsorption and nerve damage. Most recently my blood work showed an Abnormal Folic Acid reading. I also have been getting a very warm burning feeling on this left side in the stomach and the chest. I really am not getting any results from the meds and am in chronic pain. Any thoughts on this?
Thanks for your insight!
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| Dr. Safaa Mahmoud
- Wed Dec 20, 2006 4:12 pm |
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 Hello,
Anemia is a known complications for patients with inflammatory bowel diseased (ulcerative colitis and Crohn's disease) Since both ulcerative colitis and Crohn's disease involve the colon and cause chronic blood loss in stool.
On the other hand Malabsorptionn is exclusively to occur in Crohn's disease(vitamin B12/folic acid) since it affects any part of the GI(small intestine, stomach, etc)
Your symptoms could be due to anemia and the debilitating disease.
Folic acid and vitamin B12 deficiency can cause neurological symptoms like:
Paresthesias
Peripheral neuropathy
Diagnosis of vitamin B12 deficiency is based on low serum vitamin B12 levels, usually less than 200 pg per mL (150 pmol per L),
You have mentioned that your Serum folate level is not normal, how was the result , a normal range for serum folate is l 2.5-20 ng/mL.
How about your CBC and blood picture? It would be helpful if you inform us about it.
Keep us updated.
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