Mystery problem after endoscopy (but might not be related)

Posted by kfldiver @kfldiver, Mar 3, 2018

Hi my husband (62m) has some concerning symptoms for the past 4 months and we have been through a host of tests and gotten nowhere. Now it feels as if the doctors are ordering tests to look for things that the doctors can even explain to us how they would cause his symptoms, so I am hoping to get more guidance in my research of what to ask next. Here is what is going on... My husband had an routine endoscopy (and stomach biopsy) in early November due to heart burn and burping which had increased over the last two years. The doctors found a 2cm hiatle hernia and no other significant findings. He began taking Prilosec (he routinely takes a baby aspirin and is on no other medications) as recommended by the doctor just after his endoscopy (he was prescribed to take it for 8 weeks but was told to stay on it for 3 1/2 months since he began to have to take NSAIDs for the pain post endoscopy - he is now off the Prilosec). 2 days later he had significant pain/pressure in his rib cage which became intense within a week after the endoscopy. The pain moved around depending on what side he was laying on, what time of day, and was accompanied by shortness of breath and nausea. We have kept a detailed journal of this and have NOT seen any correlation with his symptoms and eating, BUT he begins to burp frequently when he is feeling bad and has bad breath. He also has light colored stools, and extreme itchyness in his lower legs (from the knees to the ankles) - neither of which are normal for him. His pain symptoms seem to come in waves and are frequently accompanied by shortness of breath and high blood pressure. He has not been able to be active since this has happened as if he even walks a short distance it (most of the time) increases his symptoms significantly. So back to the week after his endoscopy... We returned to the doctor and they did chest X-rays (no findings) and told him maybe it was arthritis (which has never made any sense to us). Two days later it was bad enough that we went to the urgent care and he had blood work and an EKG and another set of chest X-rays (slight low voltage on the ekg, no findings on the chest X-ray, high WBC 13 k/ul and high neutrophils 9.9 k/ul and high monocytes .9 k/ul and low lipase 10 u/l - all other tests came back in normal range). We were again told it was probably just arthritis. His symptoms continued and we returned to the doctor. In December his had another slightly low voltage ekg, WBC and neutrophils were both back down in normal range, and his CRP (26 mg/l) and ERS (30 mm/h) were both tested for the first time and high. He had an abdominal CT and there was a small pulmonary node and a small thyroid node (we were told both were not significant) and they said he looked constipated. The doctors sent him to a physical therapist in December and he continued through January - no results. In January he had another set of blood work - high CRP (27 mg/l) high ERS (26 mm/h) and high neutrophils (7.5 k/ul), and an echocardiogram (we were told there were no significant findings and his heart looked great). In February he again had blood work - high CRP (22 mg/l) high ERS (26 mm/h) high cyclic citrullinated peptide AB (34 u/ml) and negative rheumatoid factor (WBC was not tested in Feb). He also had a low CK test but that makes some sense after 4 months of very little activity for a normally active guy. At this point his symptoms are still coming in waves and not improving. He eats a very healthy diet (mostly whole non-processed ingredients, mostly plant based with some chicken). Before this he was a very active guy, who spent most of the last year diving, swimming, and hiking everyday (we are biologist and are jobs keep him very active) but since this has been in such excruciating pain when a wave comes that he has been unable to work or participate in any of his normally fun (or even not fun) activities. He has seen GI specialists, cardiologist, rheumatologist, internal medicine specialist, and a physical therapist. He normally docent go to the doctor and in the past I have been blown away by his pain threshold, but myself and everyone else in the family have never seen him in so much pain as this. The doctors now think maybe he has a disk issue (which would not explain the burping, itchy legs, nausea, lack of appetite, light colored stools, high WBC and other blood work outliers) and my husband is honestly fed up with going to the doctor as it feels they are just ordering tests for no reason at this point. Has anyone else ever had anything like this? Any help at all or info on similar experiences would be so very appreciated.... Thank you and sorry for so much info overload...

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Husband going through similar did you ever figure it out?

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My journey has some similarities, but not all (clay colored stool, itching, pain episodes, diarrhea/constipation).I was lucky my Gastroentologist saw abnormality on Endoscopy and repeated in 1 month where he then biopsied and Carcinoid tumor diagnosed. I say I am lucky because on Oncologist treatment now receiving monthly injection and tumor is stable with no further symptoms. This rare Neuroendocrine Carcinoid Tumor was found unexpectedly in small intestine. There is a Chromogranin A and Seratonin blood tests that is helpful. I hope this helps you question your doctors and get this resolved. Stay mentally positive and take one day at a time. Best results…

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Could be time to go to the Mayo Clinic so they can look at all these symptoms and testing that has been done.

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Hello @kfldiver

As it has been some time since you last posted, I was wondering how your husband is doing. I hope that you got some answers for his symptoms.

Will you post an update when it is convenient?

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I had an endoscopy done 5 yrs. ago which indicated that I had a 2cm hiatal hernia and was told by the GI doctor that it was nothing to worry about with no further instructions. Now 2 months ago was told that it's now a 5cm hiatal hernia with erosive esophagitis with no instructions except see you in 1 year. Had asked what can I do and was told lose weight but nothing else. There are other health problems that I have with the heart as I have stents. To make things short I read what he wrote on mychart and it said I was not a candidate for surgery (not that I want surgery) doesn't say why but am suspecting because of other areas of concern. I am a senior citizen in late 70's. Just don't know why nothing was said to me unless I asked a question which I really wasn't prepared to ask as I got nervous. Now am I supposed to wait to see what happens to me like strangling? Some info I'm getting now seems to come off of the internet. It's a shame that it has to come to this!

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@pugnose

I had an endoscopy done 5 yrs. ago which indicated that I had a 2cm hiatal hernia and was told by the GI doctor that it was nothing to worry about with no further instructions. Now 2 months ago was told that it's now a 5cm hiatal hernia with erosive esophagitis with no instructions except see you in 1 year. Had asked what can I do and was told lose weight but nothing else. There are other health problems that I have with the heart as I have stents. To make things short I read what he wrote on mychart and it said I was not a candidate for surgery (not that I want surgery) doesn't say why but am suspecting because of other areas of concern. I am a senior citizen in late 70's. Just don't know why nothing was said to me unless I asked a question which I really wasn't prepared to ask as I got nervous. Now am I supposed to wait to see what happens to me like strangling? Some info I'm getting now seems to come off of the internet. It's a shame that it has to come to this!

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pugnose: your doc gave you good advise -I know first hand how we hate to hear the words “loose weight”, however this suggestion could be the most positive action you can take. I agree we want a pill or procedure to relieve our concerns, but pills or procedures can add many problems to our health.
Perhaps a heart-to-heart with your doc about the best way to take 10 pounds off. It may be the beginning of a desirable outcome? Just my 2 cents..

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I also just had EGD done 2 weeks ago, and was told almost word for word as "Pognose" "Loose weight" as my hiatal hernia has increased a bit also.

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Curious if the GI docs tested for SIBO (small intestine bacterial overgrowth) usually done through a breath test. You can do that at home and send into the lab. Also, did they run a stool test looking for EPI?
I know how it feels to do one test after the other, but seems to be the only way to rule things out or pin it down.
My dietitian recommended using a daily product called CALM for constipation. Another dietitian thought Metamucil might be just as helpful if fiber in my diet was lacking.
Best of health to you and him 🙏

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@dbamos1945

pugnose: your doc gave you good advise -I know first hand how we hate to hear the words “loose weight”, however this suggestion could be the most positive action you can take. I agree we want a pill or procedure to relieve our concerns, but pills or procedures can add many problems to our health.
Perhaps a heart-to-heart with your doc about the best way to take 10 pounds off. It may be the beginning of a desirable outcome? Just my 2 cents..

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You are correct, thank you. However, I feel this info should have been given to me 5 yrs. ago. My hernia contains erosive esophagitis with ulcers and was given Pantoprazole 40 mg. indefinitely, which does much harm as it depletes vitamins long term and also possible kidney failure with long term use. Pills and surgery never came into my mind. However, losing weight and eating small meals plus eliminating such foods as spice, acidic foods , alcohol, smoking, carbonated beverages, low fat dairy preferable no dairy etc. may hold it at bay for awhile as surgery is out of the question for me. So I will try and do the best I can with the info I have. My prayers are for all who suffer with this and especially related problems. Yah bless

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@jer22

I also just had EGD done 2 weeks ago, and was told almost word for word as "Pognose" "Loose weight" as my hiatal hernia has increased a bit also.

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I'm using my time now trying to lose weight and have informed decisions on what my next plan will be. I've learned that losing weight is what's needed along with exercise to strenghten the diaphagm & muscle around the stomach so that the other organs aren't affected as much. If not done these symptoms will worsen. A plan to incorporate a different lifestyle starting with my meals. 3-5 small meals a day. Excluding caffeine, alcohol, smoking, fatty & fried food, citrus fruits & drinks, carbonated drinks (soda etc.) tomato based foods, chocolate , and best for me to eat low fat dairy. Many of these foods i rarely eat. It's also good to eliminate these foods especially if you have Gerd. Eat slow & thoroughly. Sip all drinks slowly. No lying down after eating at least for 3 hrs. No heavy lifting as it adds to the hernia. Propping up my head with pillows or a wedge 8-10 inches will be good especially for the Gerd. I hope some of this info will encourage you as it did me. Hang in there!

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