Gi, Oh My!

[sandymbme]

So once again I seem to be passing bright red blood in my stools. (Diarrhea, really.) My abdominal pain is epic, and I am terribly fatigued and nauseated. But I am reluctant to go to the ER for several reasons. I just saw a GI specialist at the Cleveland Clinic on Thursday, who is of the opinion that my pain is neuropathic/abdominal wall pain. He ascribed my low RBC, hemoglobin, and hematocrit numbers to me probably "just running low" on a normal basis, rather than an indication of blood loss per se. The last time I went to the hospital, they admitted me for three days, but after my colonoscopy came back with no significant findings they all but shoved me out the door.

I really don't have the money to keep running back to the ER or doctor's offices every time my symptoms worsen if all that happens is being labeled a hysterical female. My labs have been beyond screwy, with not only anemia, but potassium being low, as well as lots of issues with urine as well. My BUN and BUN/CREAT ratios were pathetically low. I can't figure out what to do. Thoughts?

Sandy

[Sallysblooms]

I don't know what to do, but I hope you feel better. Are you going to call your doctor?

[arizona girl]

Go to the ER!!!

Sandy, bright red blood in the stool and the labs you are stating along with the pain, could very well be a rupture. I know because this happened to me. Did they look at your small bowel? Colonoscopy is only the colon and endoscopy is only the upper GI, neither of these test look at the small bowel. As long as you know the blood isn't from a hemroid or a tear around the anus from straining, bright red blood is serious. If you have a rupute you can get pertinitis and die from the infections. I too was told my colon was healthy and then I ruptured within a year, 9 months after a car accident that may have triggered the intitial infection. Your labs indicated you are bleeding some where. Have they checked your iron and ferritin? You may have iron deficient anemia, which is almost always caused by a bleed somewhere.

I've been following your post and haven't posted recently because I haven't had the time. I think you show a lot of symptoms and signs that I have. I finally was diagnosed with a primary immune deficiency called CVID, it almost always has autoimmune diseases associated with it. My skin biopsy showed autoimmune autonomic neuropathy due to damage of the small fiber nerves. The thing with CVID is that if you have a defective immune system your body can't mount the normal defenses, so you have no warning signs other then pain and maybe blood, inspite of infection you won't run a fever. If I can help you out let me know.

[sandymbme]

I am loath to go to the ER as they have started to act as though I am a drug-seeking neurotic. I will call my GI doc in the morning, and if he insists I will go. But the gastroenterologist at the Cleveland Clinic was convinced that the blood I have had appearing is from internal hemorrhoids, despite the fact that the colonscopy showed them as being intact. I have had low iron levels on some previous bloodwork, and have been taking an iron supplement for several months. Despite that, my labs still show anemia. I am going to post all my abnormal labs from my last admission, which was 10/11-10/14/10.

10/11 (10:34pm)

RBC 3.33 L

Hemoglobin 11.1 L

Hematocrit 32.5 L

Urine (11:30pm)

pH 7.5 H

Urobilinogen 4.0 H

Nitrite positive

Blood Chemistry (10:34pm)

Potassium 3.3 L

Anion Gap 8 L

10/12 (10:08pm)

Hemoglobin 10.8 L

Hematacrit 33.0 L

10/13 (6:34am)

WBC 11.35 H

RBC 3.2 L

Hemoglobin 10.6 L

Hematacrit 32.6 L

MCV 101.6 H

(10:28pm)

Hemoglobin 10.0 L

Hematacrit 30.5 L

10/14

Hemoglobin 10.7 L

Hematacrit 33.3 L

It's all greek to me....

Sandy

[Tia Koul]

Gosh I sincerely don't know what any of that means.. but I would def press your GP tomorrow. Are those values always high or low? If not, I would push your gp a little. I really don't know what it means, but hang in and try to get it figured out. I was bleeding too, and i still don't know why. In the end, I think it had to be from endometriosis. Any chance? My colonoscopy was not normal, but not a cause of the bleeding. I think it was endo for me. Just thought I'd add that. Feel better!

[arizona girl]

I had very similar labs with my recent bout of anemia. I would suggest you see a hematologist. Your blood work shows anemia and your elevated wbc and nitrates show infection. Though your hemo and hema are staying steady over a 4 day period in spite of being low. It would be interesting to see your numbers now that your had a visually evident bleed. If you bleed enough from a hemroid it can cause anemia. Iron infusions and antibiotics corrected my labs, I also stopped taking a med that may have contributed to it.

Hypermobility is often associated with gi problems. Are you seeing a specialist for that. Also with a portacath can't you be prone to infection? What your doctor say?

[juliegee]

Hi Sandy-

Scary. What does your GI recommend? I think AZ Girl is right. This is nothing to mess around with. I'd definitely follow the advice of your GI & if you can't get to him/her....get to an urgent care or hospital.

Please update us when you can-

Julie

[sandymbme]

Feeling a bit better today. My home health care nurse came today to access my port/cath, and brought my lab results of the blood draw we did friday. Interestingly, the Cleveland Clinic GI's theory about my hemoglobin/hematacrit "running low" seems to be out the window. My RBC, hemoglobin and hematacrit were all well within normal range. But my MCV (104) and MCH (34.3) were both high, as well as my glucose (130). My potassium was only barely in normal range, a tenth of a point lower and it would have been low. I am going to have them draw more blood to check my CBC since I am symptomatic again. And I am thinking that a hematologist may definitely be in order. I'm just so tired of seeing so many doctors with no clear answers, I feel like I have been chasing my tail for the last 6 months or so.

Thank you all so much for your concern and support! It helps so much just to have an audience that doesn't think I'm crazy!

Sandy

[arizona girl]

I had very similar labs with my recent bout of anemia. I would suggest you see a hematologist. Your blood work shows anemia and your elevated wbc and nitrates show infection. Though your hemo and hema are staying steady over a 4 day period in spite of being low. It would be interesting to see your numbers now that your had a visually evident bleed. If you bleed enough from a hemroid it can cause anemia. Iron infusions and antibiotics corrected my labs, I also stopped taking a med that may have contributed to it.

Hypermobility is often associated with gi problems. Are you seeing a specialist for that. Also with a portacath can't you be prone to infection? What your doctor say?

[Maxine]

I hope they get down to the bottom of your lab work soon. You have a right to know what's going on.

Yes, hypermobility/EDS is associated with GI problems. 3/4 of my colon is diverticuli from weak bowel walls due to the EDS. The CLeveland Clinic is clueless about EDS/connective tissue disorders. Check this out; http://www.clevelandclinicmeded.com/live/courses/2010/marfan10/default.asp

Pretty ironic, isn't it.

Sending you a HUG,

Maxine :0)

[dianne.fraser]

Sandy

I used to work with a woman who had Crohn's - a disabling autoimmune disease that caused really terrible abdominal pain during flare-ups. There are so many different GI disorders that can cause the same symptoms - I hope that your gastroenterologist doesn't give up before checking the full spectrum of possibilities.

Nope, you're NOT crazy.

Good luck and best wishes

Dianne