Malabsorption Syndrome Questions

@kidprodigy, you might be interested in reading this discussion where @ajstaley was asking many of the same questions you are:
- Unexplained diarrhea,malabsorption,dizziness,feeling faint, confusion https://connect.mayoclinic.org/discussion/unexplained-diarrheamalabsorptiondizzinessfeeling-faint-confusion/

@jensgrdnce @peggyella @airey2 @hgarm and others may have some thoughts for you.

kidprodigy (interesting username, are you a child prodigy?) You ask about infectious agents. Have your doctors considered H. Pylori?

Hello @kidprodigy,

You certainly have had a lot of problems with your health. I can imagine that you are frustrated at not being able to find an answer to your weight loss, night sweats and other symptoms. I read some of your other posts in another discussion group and it looks like you have had a lot of tests. Have they included an upper endoscopy and colonoscopy or just the capsule test?

I'm wondering as well if there has been any lab work (specifically blood tests) to check your vitamin levels? These might provide clues to any malabsorption problems. Also, is there any anemia? Here are some links to Mayo Clinic websites that discuss malabsorption problems. The last link provides information regarding a clinical trial at Mayo that might interest you.
https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/tests-aid-diagnosis-of-an-under-recognized-disorder/mac-20431230
https://www.mayoclinic.org/drugs-supplements-vitamin-b6/art-20363468
https://www.mayo.edu/research/clinical-trials/cls-20408132

I will review the discussion thread you mentioned as it seems quite relevant to my situation!

"KidProdigy" was a nickname originally meant as a joke among my Texas Hold 'Em poker buddies and me. I was much younger than many of the other guys, but still cleaned house in charity poker tournaments we all competed in.

Yes, I tested negative for H. Pylori via the stool Ag EIA. My GI doctor still treated me with the quadruple therapy (i.e. Amoxicillin, Tetracycline, Pepto Bismol and Omeprazole) anyway, but it didn't bring me any relief.

So far, I've only had the video capsule endoscopy (i.e. PillCam SB3), but additional testing may be necessary to get a diagnosis. People with malabsorption syndromes who cannot find the cause via lab testing and/or radiology often require an upper endoscopy from what I've read.

I haven't had any lab tests to check specific vitamin levels in the blood yet.

None of my lab test results reported anemia (i.e. CBC, CMP) and I do not have diarrhea nor do I have blood or pus in my stools.

Isn't diarrhea a classic symptom of malabsorption? To lose 60+ lbs, be chronically fatigued with terrible abdominal pain and not have any diarrhea is beyond my comprehension! I think this is why my doctors (i.e. internal medicine, allergy, infectious disease, GI and rheumatology) cannot figure out what is wrong with my health!

Anonymized copies of ALL my lab test reports, radiology reports and capsule endoscopy report are available in PDF format via my CrowdMed page. If you haven' seen the reports yet, but would like to review them, let me know and I can send you the URL.

@kidprodigy - Hi! I have had a variety of digestive issues through the years and multiple endoscopes and colonoscopies in addition to large panel of lab tests- mostly at Mayo. It sounds as if you now really need endoscopy and colonoscopy with biopsies from different sites. Biopsy is also a good way to diagnose Celiac disease for example. Celiac disease could fit many of your malabsorption symptoms. It is also possible that you could have an inflammatory bowel disease, not detected by the capsule. I see that you got some good advice here and links to gain more information.

Do you mind sharing examples of diagnoses you received after upper endoscopy and/or colonoscopy procedures? I'm still at a total loss when it comes to what my diagnosis might be and you could help give me some ideas. If my question is too personal, I understand and please disregard.

Causes and types of malabsorption syndromes from Medical News Today:
https://www.medicalnewstoday.com/articles/322467#causes-and-types
I wonder if my diagnosis is hiding somewhere in this list!?

@kidprodigy - my first diagnosed autoimmune disease was Collagenous Colitis. Later on they found different non-specific inflammatory patches along entire GI tract/ probably secondary to a severe intestinal reaction to chemotherapy. All treated with immunosuppressive medication.
Chemo in itself also alters the immune system as well as severe, chronic stress
One of my daughters developed autoimmune thyroid disease and celiac disease in addition to numerous foods allergies after removal of cortisol producing pituitary tumor. Cortisol- the stress hormone. My other daughter developed celiac disease and several food allergies.
All of us also have asthma. There may be new ones coming- you never know.

I had my first upper endoscopy / colonoscopy procedure yesterday morning and it was successful!

Upper endoscopy procedure results:
No gross lesions in esophagus. Biopsied.
Z-line regular, 41 cm from the incisors.
Small sliding hiatal hernia.
Gastritis. Biopsied.
Duodenitis. Biopsied.

Colonoscopy procedure results:
Removed one, 8 mm polyp in the ascending colon.
Removed one, 5 mm polyp in the sigmoid colon.
Diverticulosis in the descending colon.
Non-bleeding internal hemorrhoids.
Terminal ileum is normal. Biopsied.
Rectum, descending colon, transverse colon, and ascending colon are normal. Biopsied.
Recto-sigmoid colon, splenic flexure, hepatic flexure, cecum, appendiceal orfice and ileocecal valve are normal.
Examination is otherwise normal on direct and retroflexion views.

My GI doc suspects the gastritis and duodenitis found on upper endoscopy are causing my unexplained weight loss, nausea, abdominal pain, bloating, gas, chills, low-grade fevers and night sweats.

This type of inflammation is most likely some form of malabsorption syndrome (i.e. Celiac disease) which should be confirmed when the pathology lab results come back in 7-14 days. What do you all think?

@kidprodigy - Congratulations!! It sounds like a successful procedure. Now you just have to wait for the pathology. You might very well have a malabsorption syndrome- celiac like you mentioned.
Please get back to us after results are in!