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    Question A Newbie with a Gross question...

    Hi Everyone
    I was diagnosed 2 weeks ago and I have kinda gross question, I have been looking on different websites and I cant find much about this.. I have been very sick to my stomach for over a week now.. I can only keep very little down and when I do.. I get bad craps for hours.. and bowel movements are not the normal colour..
    I only started taking Plaquenil 2 days ago, so I know its not a reaction to the meds
    I been having a very hard time getting out of bed and having tons of body pain... but other then that I feel ok.. so Im thinking that this is not a flu.... is this a sign of lupus?
    Last edited by ~❀ Robyn ❀~; 05-19-2011 at 02:34 PM.

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    Hi again Robyn,

    One of the difficult parts of Lupus, or any autoimmune disease, is that they tend to "overlap" which means once you have one it may turn out that you have several. Many of us with Lupus also have IBS (Irritable Bowel Syndrome). I went through what you are going through for several years without knowing what it was! You will find several threads here where we speak of bowel issues so we are used to Gross LOL.

    Extreme Fatigue is also one of the most common symptoms of Lupus. It is not just being tired. It is, as someone here called it, a "lead blanket fatigue". Even though you want to get up it feels like a lead blanket is on top of you and you just can't. This is one of the issues that they will be working on with meds.

    Hope this helps a bit!
    Mari

    Success is not final, failure is not fatal: it is the courage to continue that counts.

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    Hi Robyn,

    Irritable bowel syndrome (IBS) and Gastroparesis (Gord) are also linked to Lupus suffers, unless you have an underlining anaemia.

    Your getting spasm cramps in the bowels which is quite painfull but you do need to be tested for the above and how your feeling when getting out of bed some days, then other's your abit better Lupus does this to we all.

    I'll add info below on IBS and GORD to help you. xxx
    Last edited by Peridot20_Gem; 05-19-2011 at 02:55 PM.

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    Thank you both for responding.. Its so nice to find people who can give suport
    I have a appointment with my Rheumy on the 31. I will ask him about this.. I hate this "stomach flu" without the flu part..
    thank you again <3

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    Irritable bowel syndrome (IBS)

    .What is irritable bowel syndrome and who gets it?
    Irritable bowel syndrome (IBS) is a common functional disorder of the gut. (The gut includes the bowels.) A functional disorder means there is a problem with the function of a part of the body, but there is no abnormality in the structure. So, in IBS, the function of the gut is upset, but all parts of the gut look normal, even when looked at under a microscope. IBS causes various symptoms (listed below). Up to 1 in 5 people in the UK develops IBS at some stage in their life. IBS can affect anyone at any age, but it commonly first develops in young adults and teenagers. IBS is twice as common in women as in men..

    .What are the symptoms of irritable bowel syndrome?
    •Pain and discomfort may occur in different parts of the abdomen. Pain usually comes and goes. The length of each bout of pain can vary greatly. The pain often eases when you pass stools (motions or faeces) or wind. Many people with IBS describe the pain as a spasm or colic. The severity of the pain can vary from mild to severe, both from person to person, and from time to time in the same person.
    •Bloating and swelling of your abdomen may develop from time to time. You may pass more wind than usual.
    •Stools (sometimes called motions or faeces):
    ◦Some people have bouts of diarrhoea, and some have bouts of constipation.
    ◦Some people have bouts of diarrhoea that alternate with bouts of constipation.
    ◦Sometimes the stools become small and pellet-like. Sometimes the stools become watery or ribbony. At times, mucus may be mixed with the stools.
    ◦You may have a feeling of not emptying your rectum after going to the toilet.
    ◦Some people have urgency, which means you have to get to the toilet quickly. A morning rush is common. That is, you feel an urgent need to go to the toilet several times shortly after getting up. This is often during and after breakfast.
    •Other symptoms sometimes occur and include: nausea (feeling sick), headache, belching, poor appetite, tiredness, backache, muscle pains, feeling quickly full after eating, heartburn, and bladder symptoms (an associated irritable bladder).
    Some people have occasional mild symptoms. Others have unpleasant symptoms for long periods. Many people fall somewhere in between, with flare-ups of symptoms from time to time. Some doctors group people with IBS into one of three categories:.

    •Those with abdominal pain or discomfort, and the other symptoms are mainly bloating and constipation.
    •Those with abdominal pain or discomfort, and the other symptoms are mainly urgency to get to the toilet, and diarrhoea.
    •Those who alternate between constipation and diarrhoea.
    However, in practice, many people will not fall neatly into any one category, and considerable overlap occurs.

    Note: passing blood is not a symptom of IBS. You should tell a doctor if you pass blood..

    .Do I need any tests?
    There is no test that confirms the diagnosis of IBS. A doctor can usually diagnose IBS from the typical symptoms.

    However, a blood sample is commonly taken to do some tests to help rule out other conditions such as ulcers, colitis, coeliac disease, gut infections, etc. The symptoms of these other diseases can sometimes be confused with IBS. Tests done on the sample of blood commonly include:.

    •Full blood count (FBC) - to rule out anaemia, which is associated with various gut disorders.
    •Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) - which can show if there is inflammation in the body (which does not occur with IBS).
    •Antibody testing for coeliac disease.
    More complicated tests such as endoscopy (a look into the bowel with a special telescope) are not usually needed. However, they may be done if symptoms are not typical, or if you develop symptoms of IBS in later life (over the age of about 45) when other conditions need to be ruled out..

    .What causes irritable bowel syndrome?
    The cause is not clear. It may have something to do with overactivity of part or parts of the gut. The gut is a long muscular tube that goes from the mouth to the anus. The small and large bowel (also called the small and large intestine) are parts of the gut inside the abdomen. Food is passed along by regular contractions (squeezes) of the muscles in the wall of the gut. Pain and other symptoms may develop if the contractions become abnormal or overactive. The area of overactivity in the gut may determine whether constipation or diarrhoea develops.

    The cause of overactivity in parts of the gut is not clear. One or more of the following may play a part:


    Overactivity of the nerves or muscles of the gut. It is not known why this may occur. It may have something to do with overactivity of messages sent from the brain to the gut. Stress or emotional upset may play a role. About half of people with IBS can relate the start of symptoms to a stressful event in their life. Symptoms tend to become worse during times of stress or anxiety.

    Intolerance to certain foods may play a part in some cases. However, this is thought to be only in a small number of cases.

    Infection and bacteria in the gut. IBS is not caused by an ongoing gut infection. However, in about 1 in 6 cases, the onset of symptoms seems to follow a bout of gastroenteritis (a gut infection which can cause diarrhoea and vomiting). So, perhaps a virus or other germ may sensitise or trigger the gut in some way to cause persisting symptoms of IBS.

    Also, in some cases, symptoms get worse after taking a course of antibiotics. Antibiotics kill certain harmless or good bacteria in the gut, which changes the balance of bacterial types in the gut..

    .What are the treatments for irritable bowel syndrome?
    Many people are reassured that their condition is IBS, and not something more serious such as colitis. Simply understanding about IBS may help you to be less anxious about the condition, which may ease the severity of symptoms. Symptoms often settle for long periods without any treatment. In some cases, symptoms are mild and do not require treatment.

    If symptoms are more troublesome or frequent, one or more of the following treatment options may be advised:.

    .Fibre
    The advice about fibre in treating IBS has changed somewhat over the years. Fibre (roughage) is the part of the food which is not absorbed into the body. It remains in your gut, and is a main part of faeces (stools). There is a lot of fibre in fruit, vegetables, cereals, wholemeal bread, etc. It used to be said that eating a high-fibre diet was good at easing IBS symptoms. Then various research studies showed that a high-fibre diet can, in some cases, make IBS worse. So, one guideline on IBS (from Clinical Knowledge Summaries - cited at the end) states that 'high-fibre diets are not recommended for people with IBS'. But since that guideline was published, a review of treatments for IBS (Ford et al - cited at the end) concluded that fibre was good at easing symptoms in some people with IBS. So, the role of fibre can be confusing!

    What seems to be the case is that the type of fibre is probably important. There are two main types of fibre - soluble fibre (which dissolves in water) and insoluble fibre. It is soluble fibre rather than insoluble fibre that seems to help ease symptoms in some cases. So, if you increase fibre, have more soluble fibre and try to minimise the insoluble fibre..

    •Dietary sources of soluble fibre include oats, ispaghula (psyllium), nuts and seeds, some fruit and vegetables and pectins. A fibre supplement called ispaghula powder is also available from pharmacies and health food shops. The recent review of treatments for IBS - mentioned earlier - mentions ispaghula as the fibre supplement that seems to be the most beneficial.
    •Insoluble fibre is chiefly found in corn (maize) bran, wheat bran and some fruit and vegetables. In particular, avoid bran as a fibre supplement.
    .Foods, drinks and lifestyle
    A healthy diet is important for all of us. However, some people with IBS find certain foods of a normal healthy diet can trigger symptoms or make symptoms worse. Current national guidelines about IBS include the following points about diet, which may help to minimise symptoms:.

    •Have regular meals and take time to eat at a leisurely pace.
    •Avoid missing meals or leaving long gaps between eating.
    •Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks such as herbal teas. This helps to keep the faeces (stools) soft and easy to pass along the gut.
    •Restrict tea and coffee to three cups per day (as caffeine may be a factor in some people).
    •Restrict the amount of fizzy drinks that you have to a minimum.
    •Don't drink too much alcohol. (Some people report an improvement in symptoms when they cut down from drinking a lot of alcohol, or stop smoking if they smoke.)
    •Consider limiting intake of high-fibre food (but see the section above where an increase may help in some cases).
    •Limit fresh fruit to three portions (of 80 g each) per day.
    •If you have diarrhoea, avoid sorbitol, an artificial sweetener found in sugar-free sweets (including chewing gum) and in drinks, and in some diabetic and slimming products.
    •If you have a lot of wind and bloating, consider increasing your intake of oats (for example, oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon per day). You can buy linseeds from health food shops.
    .

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    Gastroparesis (Gord)

    What is gastroparesis?
    Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.


    The digestive system

    [Top]

    What causes gastroparesis?
    The most common cause of gastroparesis is diabetes. People with diabetes have high blood glucose, also called blood sugar, which in turn causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. Over time, high blood glucose can damage the vagus nerve.

    Some other causes of gastroparesis are

    •surgery on the stomach or vagus nerve
    •viral infections
    •anorexia nervosa or bulimia
    •medications—anticholinergics and narcotics—that slow contractions in the intestine
    •gastroesophageal reflux disease
    •smooth muscle disorders, such as amyloidosis and scleroderma
    •nervous system diseases, including abdominal migraine and Parkinson’s disease
    •metabolic disorders, including hypothyroidism
    Many people have what is called idiopathic gastroparesis, meaning the cause is unknown and cannot be found even after medical tests.

    [Top]

    What are the symptoms of gastroparesis?
    Signs and symptoms of gastroparesis are

    •heartburn
    •pain in the upper abdomen
    •nausea
    •vomiting of undigested food—sometimes several hours after a meal
    •early feeling of fullness after only a few bites of food
    •weight loss due to poor absorption of nutrients or low calorie intake
    •abdominal bloating
    •high and low blood glucose levels
    •lack of appetite
    •gastroesophageal reflux
    •spasms in the stomach area
    Eating solid foods, high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in fat or carbonation may contribute to these symptoms.

    The symptoms of gastroparesis may be mild or severe, depending on the person. Symptoms can happen frequently in some people and less often in others. Many people with gastroparesis experience a wide range of symptoms, and sometimes the disorder is difficult for the physician to diagnose.

    [Top]

    What are the complications of gastroparesis?
    If food lingers too long in the stomach, it can cause bacterial overgrowth from the fermentation of food. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction in the stomach. Bezoars can be dangerous if they block the passage of food into the small intestine.

    Gastroparesis can make diabetes worse by making blood glucose control more difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person’s blood glucose levels can be erratic and difficult to control.

    [Top]

    How is gastroparesis diagnosed?
    After performing a full physical exam and taking your medical history, your doctor may order several blood tests to check blood counts and chemical and electrolyte levels. To rule out an obstruction or other conditions, the doctor may perform the following tests:

    •Upper endoscopy. After giving you a sedative to help you become drowsy, the doctor passes a long, thin tube called an endoscope through your mouth and gently guides it down the throat, also called the esophagus, into the stomach. Through the endoscope, the doctor can look at the lining of the stomach to check for any abnormalities.

    •Ultrasound. To rule out gallbladder disease and pancreatitis as sources of the problem, you may have an ultrasound test, which uses harmless sound waves to outline and define the shape of the gallbladder and pancreas.

    •Barium x ray. After fasting for 12 hours, you will drink a thick liquid called barium, which coats the stomach, making it show up on the x ray. If you have diabetes, your doctor may have special instructions about fasting. Normally, the stomach will be empty of all food after 12 hours of fasting. Gastroparesis is likely if the x ray shows food in the stomach. Because a person with gastroparesis can sometimes have normal emptying, the doctor may repeat the test another day if gastroparesis is suspected.

    Once other causes have been ruled out, the doctor will perform one of the following gastric emptying tests to confirm a diagnosis of gastroparesis.

    •Gastric emptying scintigraphy. This test involves eating a bland meal, such as eggs or egg substitute, that contains a small amount of a radioactive substance, called radioisotope, that shows up on scans. The dose of radiation from the radioisotope is not dangerous. The scan measures the rate of gastric emptying at 1, 2, 3, and 4 hours. When more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed.

    •Breath test. After ingestion of a meal containing a small amount of isotope, breath samples are taken to measure the presence of the isotope in carbon dioxide, which is expelled when a person exhales. The results reveal how fast the stomach is emptying.

    •SmartPill. Approved by the U.S. Food and Drug Administration (FDA) in 2006, the SmartPill is a small device in capsule form that can be swallowed.The device then moves through the digestive tract and collects information about its progress that is sent to a cell phone-sized receiver worn around your waist or neck. When the capsule is passed from the body with the stool in a couple of days, you take the receiver back to the doctor, who enters the information into a computer.

    [Top]

    How is gastroparesis treated?
    Treatment of gastroparesis depends on the severity of the symptoms. In most cases, treatment does not cure gastroparesis—it is usually a chronic condition. Treatment helps you manage the condition so you can be as healthy and comfortable as possible.

    Medication
    Several medications are used to treat gastroparesis. Your doctor may try different medications or combinations to find the most effective treatment. Discussing the risk of side effects of any medication with your doctor is important.

    •Metoclopramide (Reglan). This drug stimulates stomach muscle contractions to help emptying. Metoclopramide also helps reduce nausea and vomiting. Metoclopramide is taken 20 to 30 minutes before meals and at bedtime. Side effects of this drug include fatigue, sleepiness, depression, anxiety, and problems with physical movement.

    •Erythromycin. This antibiotic also improves stomach emptying. It works by increasing the contractions that move food through the stomach. Side effects include nausea, vomiting, and abdominal cramps.

    •Domperidone. This drug works like metoclopramide to improve stomach emptying and decrease nausea and vomiting. The FDA is reviewing domperidone, which has been used elsewhere in the world to treat gastroparesis. Use of the drug is restricted in the United States.

    •Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, an antiemetic can help with nausea and vomiting. Antibiotics will clear up a bacterial infection. If you have a bezoar in the stomach, the doctor may use an endoscope to inject medication into it to dissolve it.

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    Quote Originally Posted by ~❀ Robyn ❀~ View Post
    Thank you both for responding.. Its so nice to find people who can give suport
    I have a appointment with my Rheumy on the 31. I will ask him about this.. I hate this "stomach flu" without the flu part..
    thank you again <3
    Hi Robyn,

    Your welcome from all of us and all the best with your appointment but like i said and other Diseases or autoimmune diseases you may have besides if they've done bloods to find out, can cause the the flu symptoms besides Lupus itself. xxx

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    Yes I have IBS with cramping so bad it feel like your inside are coming out ( I know gross) I wish I can give you tips but haven't found anything that will work for me. I don't eat on the go and I dont eat out as much cause of that.
    Welcome
    Hugs
    Liz

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    Quote Originally Posted by lizbond36 View Post
    Yes I have IBS with cramping so bad it feel like your inside are coming out ( I know gross) I wish I can give you tips but haven't found anything that will work for me. I don't eat on the go and I dont eat out as much cause of that.
    Welcome
    Hugs
    Liz

    LOL Only here would someone understand why I can't eat in a car!!! My doctor actually gave me a medicine for the inflammation and spasmming. It did help quite a bit and then I started having the flare from hell and I am back to where I started!
    Mari

    Success is not final, failure is not fatal: it is the courage to continue that counts.

    ~Winston Churchill~







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    Hi Robyn,
    I agree with the ladies. I have had Ulcerative Colitis before Lupus. almost 11 years now. this sounds definitely like an IBD. all they need to do is take a sample of your bowel to find out! and possible colonoscopy! but thats nothing . trust me
    Good luck!!
    It's very annoying condition to live with! Uncomfortable, painful, embarrassing etc.

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