Doctors Lounge - Rheumatology Answers
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Forum Name: Rheumatology Topics
|newmom08 - Thu Jan 22, 2009 2:05 pm||
I have had several blood panels done two checked my ANA and it was positive with borderline titers. I have been diagnosed with Raynauds syndrome two years ago. I have been struggling with severe abdominal pain the last two years. My first colonoscopy was performed two years ago and a biopsy was performed of my small bowel showing slight inflamation throughout the region. My second colonoscopy was done 12-23-2008 due to the localised pain one inch to the direct right of my belly button. The pain is just like a knife is in that spot, very localised. The most recent colonoscopy showed a normal mucosa with normal random biopsies. But when the doctor attempted to get near my small bowel opening the small bowel began to spasm so bad she couldn't get the biopsy. After the procedure she put me on two anti-spasmatic medicines. They worked for about a week and the pain came back even worse then before. My diet doesn't affect the pain. Nothing makes it better. I will be having a small bowel x-ray in a week to see if they can find anything that way. I was given more pain killers yesterday at my follow up appointment. I would like someone just to listen to my story and want to help find me answers. I don't know if this is related but I am finding that I am unable to lose weight. I gained 12 lbs in one month and I consume no more then 2,000 calories a day. I eat very healthy no fast food my biggest food sin is diet soda. A month ago I reduced my calorie intake to 1,700 and added prescription Xenical. I do cardio 40 min. 3-4 times a week with no weight training so I know my lack of weight loss isn't due to muscle gain. I am 5'9'' and 180lbs. One year ago I was 159lbs. I am slipping into a deep depression due to this weight change and pain I'm experiencing. I am barely 21 years old and I suffer everyday with this horrible pain. Please someone I beg you to take the time to read my story and health history and tell me if you can help.
|Tom Plamondon PA-C - Mon Feb 02, 2009 11:49 am||
Thanks for writing in.
A marginally positive ANA commonly occurs in the general population so this lab alone does not diagnose lupus.
There can be an association of lupus with Raynauds...again just another piece to the diagnostic puzzle.
If we are thinking lupus as a diagnosis, some GI manifestations include peritonitis (inflammation or infection of the abdominal wall), ischemic vasculitis, and diarrhea producing enteropathy which causes loss of protein.
Weight gain can occur with lupus if the kidney cause loss of protein (nephrotic syndrome) or with enteropathy.
Your family physician may do a complete review of system including questions about skin rashes, hair loss or hair growth, joint inflammation, chest pain, shortness of breath, etc. He may also consider an abdominal CT, further labs like urine analysis with microscopic exam and a 24 hour urine collection checking level of free cortisol and protein.
With the weight gain, problems with thyroid or adrenal gland should be explored.
Regarding bowel spasm, some patients have found peppermint oil (in tea or capsule) to ease irritable bowel.
Keep us posted and take care.
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