Recurring Gastrointestinal Issues: Causes and Treatment Insights

Gastrointestinal issues have been recurring for nearly two months?

1.
On December 24 of last year, I suddenly experienced chills, fatigue, weakness, dizziness, and gastrointestinal pain (diarrhea 2-3 times daily).
The clinic diagnosed it as a gastroenteritis virus, and I was treated with symptomatic medication for three days.
I managed my diet lightly for two weeks before feeling better.
A week later, on January 20, the same symptoms recurred (chills, fatigue, weakness, dizziness, gastrointestinal pain, and diarrhea 2-3 times daily).
This time, I experienced chills for three weeks (cold hands and feet), fatigue and excessive sleepiness for two days, and dizziness for a week.
My stomach pain and bloating improved gradually with gastrointestinal medication, but after a few days, the stomach pain and bloating returned, occurring repeatedly.
I have been on a light diet since January 20.
2.
When the symptoms first appeared on December 24, I had tachycardia (heart rate 105-120) that lasted for two days before gradually subsiding.
When the symptoms recurred on January 20, I again had tachycardia (heart rate 105-120) for three days before it gradually improved.
(An electrocardiogram showed tachycardia without arrhythmia.)
3.
I visited a gastroenterology clinic on January 23 and January 26, and I was referred to a major hospital to check for other underlying factors.
Blood tests were normal, but imaging revealed a shadow in the right lower abdomen, and a 2.5 cm vascular cyst on the fallopian tube was removed.
The doctor stated that this would not cause gastrointestinal discomfort.
4.
After laparoscopic surgery on February 16, I experienced bowel sounds, bloating, diarrhea, and abdominal pain.
This morning (February 19), I had a bowel movement without diarrhea, but there was fresh blood and a small piece of membrane floating.
I have hemorrhoids near the anal area.
This morning (February 19), I also woke up with tachycardia (heart rate 95-105), sharp pain in the left chest, slight shortness of breath, dizziness, and headache, along with abdominal pain.
Currently, I am at home post-surgery, taking a week of antibiotics and painkillers.
The doctor said the antibiotics are for preventive purposes, and I can skip the painkillers if I don't have pain, but the nurse advised that I should not stop the antibiotics.
I am afraid to stop taking any medication.
After taking the antibiotics, I wait 1.5 hours before taking a probiotic, which helps alleviate bloating and pain somewhat.
5.
Doctor, could the antibiotics be the main cause of my gastrointestinal discomfort today? Could the tachycardia and chest pain with slight shortness of breath be related to intestinal inflammation? What could be the underlying issue causing the recurring gastrointestinal symptoms? What do you recommend for further consultations (I have already seen cardiology, gastroenterology, hematology-oncology, and surgery)?

Xiao Qin, 40~49 year old female. Ask Date: 2024/02/19

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please discuss the actual situation and necessary examinations and treatments with the gastroenterology attending physician.

Reply Date: 2024/02/19

More Info

It sounds like you have been experiencing a complex array of gastrointestinal symptoms that have significantly impacted your quality of life. Your symptoms, including chills, fatigue, dizziness, abdominal pain, and diarrhea, suggest a possible underlying gastrointestinal issue that may not be fully resolved. Let's break down your concerns and provide some insights based on your description.

1. Recurring Gastrointestinal Symptoms: The recurrence of your symptoms, particularly after an initial viral gastroenteritis diagnosis, raises the possibility of a chronic condition. Conditions such as Irritable Bowel Syndrome (IBS), inflammatory bowel disease (IBD), or even food intolerances could be contributing factors. IBS is characterized by recurrent abdominal pain and changes in bowel habits, which may include diarrhea or constipation. Given your symptoms of abdominal pain and diarrhea, it would be prudent to consider this diagnosis, especially if no other organic causes have been identified.

2. Antibiotics and Gastrointestinal Discomfort: You mentioned that you are currently on antibiotics post-surgery. Antibiotics can disrupt the normal gut flora, leading to gastrointestinal discomfort, including diarrhea and bloating. This disruption can sometimes result in antibiotic-associated diarrhea or even Clostridium difficile infection, especially if the antibiotics were broad-spectrum. It is essential to monitor your symptoms closely and discuss with your physician whether the antibiotics could be contributing to your gastrointestinal issues.

3. Heart Rate and Chest Pain: The episodes of tachycardia (increased heart rate) and chest pain you are experiencing could be related to anxiety, especially given the stress of your medical situation. However, it is crucial to rule out any cardiac issues, particularly since you have experienced these symptoms alongside gastrointestinal distress. While it is less common for gastrointestinal inflammation to cause significant cardiac symptoms, the stress and discomfort from your ongoing symptoms could certainly contribute to feelings of anxiety, which can manifest as palpitations and chest discomfort.

4. Post-Surgical Symptoms: After abdominal surgery, it is not uncommon to experience changes in bowel habits and gastrointestinal discomfort. This can be due to several factors, including changes in diet, the effects of anesthesia, and the body's healing process. The presence of fresh blood in your stool is concerning and should be addressed immediately with your healthcare provider, as it could indicate a complication such as a bleeding ulcer or hemorrhoids, especially given your mention of internal hemorrhoids.

5. Next Steps for Evaluation: Given the complexity of your symptoms and the fact that you have already consulted multiple specialists, it may be beneficial to return to your gastroenterologist for a comprehensive evaluation. They may recommend further diagnostic tests, such as a colonoscopy, to rule out any underlying conditions that could be causing your symptoms. Additionally, discussing your symptoms with a dietitian may help identify any food intolerances or dietary changes that could alleviate your gastrointestinal distress.

In summary, your symptoms are multifaceted and could be due to a combination of factors, including post-surgical changes, antibiotic effects, and possibly an underlying gastrointestinal disorder. It is crucial to maintain open communication with your healthcare providers, advocate for further evaluation if needed, and consider lifestyle modifications that may help manage your symptoms. Keeping a symptom diary may also be beneficial in identifying triggers and patterns in your gastrointestinal health.

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