Lifetime of undiagnosed GI symptoms + asthma and waiting for genetic testing

shretl

New member
Hi everyone. I have a really long and complicated medical history, so I'll try to truncate it as much as I can.

I'm an almost-34 year old female of (as far as we know!) 100% Ashkenazi descent. I was born six weeks prematurely and required oxygen and feeding tubes. At birth, I was diagnosed with lactose intolerance and hyperactive airways. Throughout infancy, I had chronic colds, bronchitis, and diarrhea. My mother was told that I was swallowing mucus instead of expelling it, causing the diarrhea. She never really believed it, but could never get a better answer. She had to take a two year sabbatical from teaching to care for me-- a chief reason being to maintain my weight.

As far back as I can remember, I was sick. I do not ever remember feeling well. I would get sick every time I ate, coughing up mucus and whatever just went down. I always felt weak and run down. I never remember having an appetite or craving food. It was always this chore I had to do-- eat and be sick.

When I was seven, I had a full ENT workup, where I was re-diagnosed with bronchial asthma. (I still struggle with it today). The GI symptoms just got worse and were never addressed beyond shrugs from our doctor. I would have dumping episodes every time I ate. Compounded with all of this, I was diagnosed with panic disorder at age nine and have been in treatment most of my life.

As I got older, the malabsorption worsened to such a degree that I couldn't eat out because I wouldn't make it into the bathroom in time. At 17, without a single ounce of labwork, I was given the diagnoses of IBS-D and GERD. To date, I have never responded to any IBS or reflux treatments given. Due to my GI symptoms, I became increasing phobic about going out and developed agoraphobia.

Finally, four years ago, my symptoms became a crisis situation. I lost almost 30 lbs in less than 2 months. Every meal would go straight through me and developed what I was told was protein edema in my abdomen and legs. I was rushed to the ER where, awaiting labwork, I was wrongfully given an eating disorder diagnosis without an evaluation. That labwork came back positive for c. difficile, which boggled the doctors as I hadn't been on antibiotics, proton-pump inhibitors, and hadn't been near a public restroom in years. My vitamins (A, D, iron, etc) and minerals (potassium, etc) were dangerously low. I had iron infusions and PPN lines, which temporarily raised my levels. During my hospitalization, I had endo and colonoscopies, biopsies, sonograms, and an MRI. During that period, everyone thought I had Celiac or Crohns, but both the biopsies and bloodwork came back negative. The scopes showed a lot of damage from c. diff, chronic reflux and diarrhea. I had a prolapse and sludge in my gallbladder before I was 30. The doctor who did the scopes ever-so-kindly told me that my guts look liked they belonged to an 85 year old with a lifetime of chronic GI issues.

Unfortunately, I relapsed with c. diff multiple times. During my second hospital stay for c. diff, I was down to 89 lbs and put on a 6,000 calorie-a-day diet and developed refeeding syndrome. I finally had an FMT procedure last June, which was successful of curing the c. difficile...

But nothing else got better. The dumping episodes I've experienced my entire life continue. The diarrhea and mucus output have worsened and I was put on an Imodium regime that I follow to this day-- 3 1/2 days on, 3/ 1/2 days off. So I have 3 1/2 days where I can go out, go to school (I'm a doctoral student), and try to live a fairly normal life. Then it's 3 1/2 days (Thursday night through Sunday night) where I live in the bathroom. The edema persists, my weight continues to remain dangerously unstable. My doctors (GI, infectious disease, and endocrine) grew nasty and unhelpful, declaring, without performing further labwork, that I had 'refractory IBS' and the edema was 'body dysmorphia'. Despite endless conversations with my MD/PHD therapist and RD/MS dietitian to my doctors, confirming this was not psychosomatic or psychological and that I was truly very physically ill, I could not get a medical doctor to take my symptoms seriously. My vitamin levels fell to single digits. My teeth started to break. My hair fell out. Going to the store required a full day of rest afterward. Finally, in a desperate attempt to be heard, I went back to the GI doctor who performed my FMT and begged him to help.

I did a 72 hour stool test and was diagnosed with severe exocrine pancreatic insufficiency. My current bloodwork shows my Vitamin D at 3 ng/ml and my Vitamin A at less than 0.03 mg/l. I'm very anemic and losing protein all over the place. Finally, last month, my GI ordered genetic testing for CF. Nearly all of my family was wiped out in WWII, so we don't have a lot of family history to go by.

I find myself in the horrible position of hoping the tests come back positive for mutations so I can finally have some answers and hopefully get medical treatment for a very real organic illness I have bee struggling with all of my life and, conversely, feeling deeply guilty and ashamed for hoping the result is CF.

Thank you for allowing me to voice all of this. It's been 18 days, and I'm still waiting for the results. Has anyone had a similar experience?
 

Ratatosk

Administrator
Staff member
While my child was diagnosed shortly after birth due to meconium ileus/bowel obstruction, we had no family history of CF and both sides have genealogy records which go back hundreds of years.

Hopefully you'll get some answers soon and the doctors can treat the symptoms. Meanwhile, due to your pancreatic insufficiency have they at least put you on pancreatic enzymes to help you digest fat? Have they run any sputum cultures to see if you're growing any common cf bugs and which antibiotics those bugs, if any are sensitive to?
 

shretl

New member
Thank you so much for your reply!

I haven't had any workup done related to a CF diagnosis, so no sputum cultures. My GI is working on a wait-and-see approach, which is dragging this out.

As per enzymes, I really have a ton of questions about that! I have ankyloglossia (tongue-tie) and cannot swallow pills, so I was initally placed on Ultresa because it can opened in and mashed into bananas. I started taking it right after the EPI diagnosis and my dosage was initially at 20,700 UI x 2 per meal and then it was increased to 3. I found my weight started to stabilize a little more and I felt less ill after meals. Unfortunately, there was apparently some kind of manufacturing issue in March and I was unable to get Ultresa for a few months, so I was switched to Zenpep, which also can be opened. I haven't found it to be as effective as Ultresa, and when I told my GI this, he told me that I was supposed to take the capsules during the meal, not all at once right before I ate, and that I should 'play around' with my dosage. This has me at a complete loss. I have no idea what dosage would be correct and can't figure out exactly how I'm supposed to space out the granules from the open capsules. I'm trying to find a GI or endo who has more experience with this-- even if the genetic tests are negative. I'm in NYC, so you'd think this would be easy, but I'm really struggling. Fat is, of course, a huge issue, but I seem to have an even harder time with proteins. Is this unheard of?
 

Ratatosk

Administrator
Staff member
When ds was a baby and we poured the contents of the capsules onto a spoonful of baby bananas (or syrup, jelly, fruit, ketchup) we gave them to him all at once because we needed to make sure the beads were rinsed down and didn't stay in his mouth. Now that he's older and takes capsules whole, we space them out. Sometimes he still takes them all at once. Depends upon how quickly he eats. The key is making sure they get to the small intestine to help break down fat.

I do believe there are some people on this site who are very pancreatic insufficient and have issues with protein as well.
 

shretl

New member
Thanks again for your reply. I've gotten my share of mouth sores from granules not going down immediately. I can't imagine what that is like for a baby! I really hope your ds is doing okay these days.

I got word today that my results were back and it was urgent I speak to my doctor, but apparently not urgent enough for him to actually call me back. :/ Hopefully by tomorrow, I will have answers.
 

jaimers

Super Moderator
Hope you were able to talk to your doctor and find out what the heck is going on! You have been through the wringer. Hopefully you'll get some answers soon. I know travel may be very difficult, perhaps not even a possibility, with agoraphobia, but maybe some place like the Mayo clinic or a similar hospital that routinely deals with more rare diseases and symptoms would be able to help you find a diagnosis so you don't have to live like this.
There is a doctor in Boston named Stephen Friedman (I believe the spelling is correct). he is a CF GI specialist and comes highly recommended by several people here. Could be worth trying to get an appointment with him.
Wishing you the best!
 
W

welshwitch

Guest
Let us know what the results are! So sorry you are struggling. I hope you get answers soon. If it's any consolation, many people on this forum who have been diagnosed with CF later (in their 30s) report feeling MUCH better once they on proper medication and treatment.

Sending you strength! <3
 

Simba15

Member
You certainly have the symptoms. May the best result happen for you.

Hi everyone. I have a really long and complicated medical history, so I'll try to truncate it as much as I can.

I'm an almost-34 year old female of (as far as we know!) 100% Ashkenazi descent. I was born six weeks prematurely and required oxygen and feeding tubes. At birth, I was diagnosed with lactose intolerance and hyperactive airways. Throughout infancy, I had chronic colds, bronchitis, and diarrhea. My mother was told that I was swallowing mucus instead of expelling it, causing the diarrhea. She never really believed it, but could never get a better answer. She had to take a two year sabbatical from teaching to care for me-- a chief reason being to maintain my weight.

As far back as I can remember, I was sick. I do not ever remember feeling well. I would get sick every time I ate, coughing up mucus and whatever just went down. I always felt weak and run down. I never remember having an appetite or craving food. It was always this chore I had to do-- eat and be sick.

When I was seven, I had a full ENT workup, where I was re-diagnosed with bronchial asthma. (I still struggle with it today). The GI symptoms just got worse and were never addressed beyond shrugs from our doctor. I would have dumping episodes every time I ate. Compounded with all of this, I was diagnosed with panic disorder at age nine and have been in treatment most of my life.

As I got older, the malabsorption worsened to such a degree that I couldn't eat out because I wouldn't make it into the bathroom in time. At 17, without a single ounce of labwork, I was given the diagnoses of IBS-D and GERD. To date, I have never responded to any IBS or reflux treatments given. Due to my GI symptoms, I became increasing phobic about going out and developed agoraphobia.

Finally, four years ago, my symptoms became a crisis situation. I lost almost 30 lbs in less than 2 months. Every meal would go straight through me and developed what I was told was protein edema in my abdomen and legs. I was rushed to the ER where, awaiting labwork, I was wrongfully given an eating disorder diagnosis without an evaluation. That labwork came back positive for c. difficile, which boggled the doctors as I hadn't been on antibiotics, proton-pump inhibitors, and hadn't been near a public restroom in years. My vitamins (A, D, iron, etc) and minerals (potassium, etc) were dangerously low. I had iron infusions and PPN lines, which temporarily raised my levels. During my hospitalization, I had endo and colonoscopies, biopsies, sonograms, and an MRI. During that period, everyone thought I had Celiac or Crohns, but both the biopsies and bloodwork came back negative. The scopes showed a lot of damage from c. diff, chronic reflux and diarrhea. I had a prolapse and sludge in my gallbladder before I was 30. The doctor who did the scopes ever-so-kindly told me that my guts look liked they belonged to an 85 year old with a lifetime of chronic GI issues.

Unfortunately, I relapsed with c. diff multiple times. During my second hospital stay for c. diff, I was down to 89 lbs and put on a 6,000 calorie-a-day diet and developed refeeding syndrome. I finally had an FMT procedure last June, which was successful of curing the c. difficile...

But nothing else got better. The dumping episodes I've experienced my entire life continue. The diarrhea and mucus output have worsened and I was put on an Imodium regime that I follow to this day-- 3 1/2 days on, 3/ 1/2 days off. So I have 3 1/2 days where I can go out, go to school (I'm a doctoral student), and try to live a fairly normal life. Then it's 3 1/2 days (Thursday night through Sunday night) where I live in the bathroom. The edema persists, my weight continues to remain dangerously unstable. My doctors (GI, infectious disease, and endocrine) grew nasty and unhelpful, declaring, without performing further labwork, that I had 'refractory IBS' and the edema was 'body dysmorphia'. Despite endless conversations with my MD/PHD therapist and RD/MS dietitian to my doctors, confirming this was not psychosomatic or psychological and that I was truly very physically ill, I could not get a medical doctor to take my symptoms seriously. My vitamin levels fell to single digits. My teeth started to break. My hair fell out. Going to the store required a full day of rest afterward. Finally, in a desperate attempt to be heard, I went back to the GI doctor who performed my FMT and begged him to help.

I did a 72 hour stool test and was diagnosed with severe exocrine pancreatic insufficiency. My current bloodwork shows my Vitamin D at 3 ng/ml and my Vitamin A at less than 0.03 mg/l. I'm very anemic and losing protein all over the place. Finally, last month, my GI ordered genetic testing for CF. Nearly all of my family was wiped out in WWII, so we don't have a lot of family history to go by.

I find myself in the horrible position of hoping the tests come back positive for mutations so I can finally have some answers and hopefully get medical treatment for a very real organic illness I have bee struggling with all of my life and, conversely, feeling deeply guilty and ashamed for hoping the result is CF.

Thank you for allowing me to voice all of this. It's been 18 days, and I'm still waiting for the results. Has anyone had a similar experience?
 

Printer

Active member
Google Steven D. Freedman, MD, PhD. He is in Boston at the Beth Israel Deaconess Medical Center.

I was dx at age 47. I have lived much of your story.
 
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