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I’m currently waiting to se a gi specialist and an internal…

Hello. I’m currently waiting to...
Hello. I’m currently waiting to se a gi specialist and an internal med because my family physician does not know what to do of all this. I’ve been feeling ill ( weak unwell nausea ) for couple of months. I’ve been also having pale stool sticky( not white just pale brown -yellow ) that’s not going back to normal ...for almost a year. And the only thing that came up on tests is a mildly longer spleen.. at 14,5 cm, a 4 mm micro cyst on liver and my urobilinogene is 34 instead of 17.
The bilirubin is ok. And the LFT are ok as well.
Any idea? I also have abdominal discomfort. The urobilinogene increased makes sense with the pale stool. However it does not because all the other values are normal range.
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Answered in 1 minute by:
3/17/2018
Connie Pennington
Category: Medical
Satisfied Customers: 676
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
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Hello. I am Dr. Pennington. I am a colorectal surgeon. May I ask how old you are?

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Customer reply replied 5 months ago
Young .. 33
Customer reply replied 5 months ago
honestly it’s a very annoying situation. As I’m pharmacy owner ( pharmacist) and have two young children!

Indeed you are young. Tell me more about you. Any current medical problems being treated by pharmaceuticals? Any surgical history?

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Customer reply replied 5 months ago
Nothing

How much of a medical work up have you had? Labs/CT scan, anything else?

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Customer reply replied 5 months ago
Am awaiting an abdominal mri
Customer reply replied 5 months ago
Had a ct which showed the “elongated “ spleen
Customer reply replied 5 months ago
I can send you the lab work. But nothing major. My ferritin is quite low ...
Customer reply replied 5 months ago
I also have random pain around si joint and my spine. But I don’t know if it’s relevant
Customer reply replied 5 months ago
1
Customer reply replied 5 months ago
2
Customer reply replied 5 months ago
3

OK. Hemolytic anemia can cause an enlarged spleen and urobilinogen to be elevated. Any history of infection/alcohol use/cirrhosis/gallbladder issues?

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Customer reply replied 5 months ago
Occasional wine
Customer reply replied 5 months ago
But would it not show in blood work?

Your iron is quite low, how is that being treated?

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Customer reply replied 5 months ago
Dr was going to prescribe iron pills
Customer reply replied 5 months ago
Also was having quite heavy and liquid periods it’s as if I was cut... had a pelvic and transvag us
Customer reply replied 5 months ago
Don’t know if it is related
Customer reply replied 5 months ago
have travelled to Cuba and Haiti before all this began. So again don’t know if it could be some weird parasite or

Have you been exposed to any pharmaceuticals in the last 6 months? Antibiotics, in particular Levofloxacin?

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Customer reply replied 5 months ago
Only cipro
Customer reply replied 5 months ago
But this all started before

Babesia parasites can cause hemolytic anemia.

The floxin's are know culprits for causing drug induced hemolytic anemia.

Ok, if it started before.

I would love to do a comprehensive stool analysis to look at the microbiome, malabsorption and full parasite panel. Also a NutraEval to look specifically at Vitamin co factors. This is all functional medicine testing that a general practitioner many not use.

I use Genova Diagnostics for these tests. They are in Ashville, N.C. When will you see the GI specialist?

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What did the pelvic u/s show? Any fibroids?

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Customer reply replied 5 months ago
The thing is I’m in Montreal :(
Customer reply replied 5 months ago
It did notable fibroids
Customer reply replied 5 months ago
Not show
Customer reply replied 5 months ago
If mri and ct don’t show any “lesions” than it’s not a cancer or something?
Customer reply replied 5 months ago
It would be some other cause that’s just hiding ?

Goodness, well heavy periods can cause anemia, iron def type. Usually there is a reason for the heavy periods though. Blood born cancers do not show up on scans, you would need a bone marrow biopsy, but it does not sound like a blood borne caner, as your CBC with differential was ok, just lymphocyte slightly low. Could you be exposed to anything chemical, heavy metal....do you smoke?

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Customer reply replied 5 months ago
I don’t smoke
Customer reply replied 5 months ago
I thought about lymphoma or leukemia
Customer reply replied 5 months ago
But this is a public health care system so no one will do a bone marrow biopsy
Customer reply replied 5 months ago
I was worried it’s something wrong with the liver and thats causing heavy periods
Customer reply replied 5 months ago
pale stool

It just does not fit. Tell me about the abdominal pain. After meals, any relation to meals? What types of things do you eat? Dairy? Gluten?

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Have you been tested for Celiac disease?

Take a look at this quick article:

http://www.cureceliacdisease.org/wp-content/uploads/341_CDCFactSheets2_Symptoms.pdf

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Customer reply replied 5 months ago
Yeah I was tested for celiac. It’s not that.
Customer reply replied 5 months ago
No nothing fits :(
Customer reply replied 5 months ago
yet I’m not ok and have random off values
Customer reply replied 5 months ago
Honestly it’s not the pain that bother me

I agree. Something is going on. You can do Genova Testing in Montreal. They ship world-wide. A good look at the microbiome and advanced labs would be in order.

Do you have access to an integrative medicine specialist?

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Customer reply replied 5 months ago
Rather my unwellness
Customer reply replied 5 months ago
No :(
Customer reply replied 5 months ago
What is the Genova test ?
Customer reply replied 5 months ago
what other labs ?
Customer reply replied 5 months ago
the pain is more like discomfort

https://www.gdx.net/product/comprehensive-digestive-stool-analysis-cdsa

https://www.gdx.net/product/nutreval-nutritional-test-plasma

https://www.gdx.net/product/allergix-igg4-food-antibodies-90-food-sensitivity-test-serum

These are links to 3 of the most common tests I use with Genova when there is a "medical mystery" patient. They are a stool test, urine test and blood test to look at the microbiome, food sensitivities (you can be neg for Celiac and still wildly sensitive to gluten) and a complete vitamin profile.

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Customer reply replied 5 months ago
Ok
Customer reply replied 5 months ago
what about the urobilinogene? And other values normal? It’s not a “ nrmaol “ occurrence ... what could be going on?

1. Lab error--repeat tests

2. A functional issue (real, but will not show up on standard testing)

3. Extreme stress manifestation, because these bodies to react to stress.

4. Upper GI issues, like H. Pylori

How is your stress level?

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Customer reply replied 5 months ago
I don’t have h pylori
Customer reply replied 5 months ago
Well I’m stressed and frustrated because I don’t feel well and the cause is not found :(
I used to be super active and now not able to do much
Customer reply replied 5 months ago
Because my stool is really pale and it makes sense with the urobilinogene but not with the rest

Pale stool can be pancreatic insufficiency. Have you tried digestive enzymes?

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Customer reply replied 5 months ago
No
Customer reply replied 5 months ago
the insufficiency would just pop up ?
Customer reply replied 5 months ago
Lipase amylase ok

Without further testing, I simply do not know. I am glad you are to see a GI specialist. An EGD may be in order. I am sorry this is so frustrating! Keep seeking medical attention. If you like I can opt out of the question which would open it up to other practitioners?

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Customer reply replied 5 months ago
What’s an egd?

endoscopy to look into the stomach. Esophagogastroduoenoscopy

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Customer reply replied 5 months ago
Also i don’t know but my dad passed away of unknown origin metastatic neuroendocrin cancer. It couldn’t be that if nothing was seen on imaging ?

Imaging often misses small tumors--and sometimes they are in the pancreas. The MRI will be better than a CT scan. Sometimes we use somatostatin CT scans and capsule endoscopy. Be sue to tell your GI physician about this history.

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Customer reply replied 5 months ago
Oh I forgot. I did a mr enterography. And they didn’t see anything. I’m doing the abdominal mri out of precaution...
Customer reply replied 5 months ago
Also the dr said that that kind of small tumor would not cause all these symptoms even if it were to be there :(
Customer reply replied 5 months ago
I find it crappy that you are saying all these things and that the dr here just dismissed the concerns ...
Customer reply replied 5 months ago
Last is capsule endoscopy better than EUS ? I read Eus is quite good for pancreatic tumors

They are different. I like EUS, but capsule endoscopy goes all the way through the small bowel. So, both are good.

I am so sorry you have not gotten to the bottom of this! Since the standard work up is not turning up anything, a functional medicine work up may be the ticket. That is why I got into functional medicine! I find it quite helpful!

https://www.ifm.org/find-a-practitioner/?country=CA&city=&province=&state_us=&state_ca=&postal_code=&pos=&advanced_search=&ifm_certified=&practitioner-first-name=&practitioner-last-name=&insurance=&medicare=&online=&phone=&primary-degree=&languages=

There is a practitioner in Montreal according to the IFM website.

I sure hope that helps! Keep seeking, and good luck to you!

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Customer reply replied 5 months ago
Thank you
Customer reply replied 5 months ago
Last thing. I promise
The mr entero looked at the small bowel. And saw nothing. The dr was talking about maybe EUS TO complete the work up
Would capsule endoscopy still me necessary ?

I would not think so. I think the MR Enterography would be superior.

Connie Pennington
Category: Medical
Satisfied Customers: 676
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
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Connie Pennington and 87 other Medical Specialists are ready to help you
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Customer reply replied 5 months ago
Ok. Thank you so much
Customer reply replied 5 months ago
I wish you were in Montreal!

Thank You! I wish you the best!

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