Gastrointestinal Issues After Heat Stroke in SLE Patients

Gastrointestinal discomfort following heatstroke?

Hello, Doctor.
I am an SLE patient.
After suffering from heatstroke in mid-July last year, I have been experiencing indigestion, bloating, borborygmi, and excessive flatulence.
Before bowel movements, I often pass gas, and my abdomen undergoes significant peristalsis, accompanied by loud gurgling sounds (with no abdominal pain, no constipation, normal appetite, and normal stool color and shape).
After researching gastrointestinal discomfort online, I learned that consuming yogurt or probiotics could help.
I have been drinking yogurt for about two months, and my borborygmi and flatulence have significantly decreased, leading to an overall improvement in my condition.

Before the heatstroke, my gastrointestinal health was relatively good; I rarely experienced excessive gas or bloating, and I could sit or lie down right after eating without any digestive issues.
My mood and stress levels did not affect my gastrointestinal comfort.
In October, I consulted a gastroenterologist.
After listening to my symptoms, the doctor suggested that it seemed more like irritable bowel syndrome (IBS).
An abdominal ultrasound was performed, and I was prescribed the following medications: Kascoal, Catilon, and Splotin, one of each to be taken three times a day for seven days.
However, after starting the medication, my symptoms worsened compared to before.
My left abdomen was constantly moving, producing loud noises, and the frequency of gas increased significantly.
After four to five days, I stopped taking the medication, but the symptoms did not resolve and severely impacted my social life.
It was only after taking probiotics for over four months that my symptoms began to improve gradually.
Could you please explain why my gastrointestinal system reacted so strongly to these medications? Is my body rejecting these drugs? Do I need to undergo any further tests? Currently, I am taking SLE medications, including 1.5 steroid tablets per day, 1 quinine tablet per day, 1 Mycophenolate mofetil tablet per day, and 1 Bokey tablet per day.

Anne, 40~49 year old female. Ask Date: 2024/03/04

Dr. Hu Guozheng reply Gastroenterology and Hepatology

The manifestations of lupus erythematosus may also include gastrointestinal discomfort.
It is recommended that you consult with a rheumatology and immunology specialist for evaluation.
Thank you.

Reply Date: 2024/03/04

More Info

Gastrointestinal issues following heat stroke, particularly in patients with systemic lupus erythematosus (SLE), can be complex and multifactorial. Your symptoms of indigestion, bloating, excessive gas, and increased bowel sounds after experiencing heat stroke suggest a possible disruption in your gastrointestinal (GI) function. This disruption may be exacerbated by the underlying autoimmune condition, SLE, which can affect various systems in the body, including the GI tract.

After heat stroke, the body undergoes significant stress, which can lead to alterations in gut motility and sensitivity. The symptoms you describe, such as increased bowel sounds and gas, may indicate a condition known as irritable bowel syndrome (IBS), which is characterized by a combination of abdominal discomfort and altered bowel habits. Stress and anxiety, which can be heightened after an acute event like heat stroke, are known triggers for IBS symptoms.

The fact that you experienced improvement with probiotics and yogurt suggests that your gut microbiota may have been disrupted. Probiotics can help restore the balance of beneficial bacteria in the gut, which is essential for proper digestion and overall gut health. The reduction in symptoms after taking probiotics indicates that your gut may have been sensitive to changes in its microbial environment, possibly due to the stress of heat stroke or the impact of SLE.

Regarding the medications prescribed by your gastroenterologist, it is not uncommon for some patients to experience adverse reactions to certain GI medications. The medications Kascoal, Catilon, and Splotin may have side effects that can include increased gas production or changes in bowel habits. It is possible that your gastrointestinal system reacted negatively to these medications, leading to the exacerbation of your symptoms. This does not necessarily mean that your body is rejecting the medications, but rather that your GI tract may be particularly sensitive at this time.

Given your ongoing symptoms and the significant impact they have on your social life, it may be beneficial to consider further evaluation. Additional tests, such as a hydrogen breath test to check for lactose intolerance or small intestinal bacterial overgrowth (SIBO), could provide more insight into your digestive issues. Furthermore, a thorough review of your current medications, including those for SLE, is essential, as some medications can have gastrointestinal side effects.

In managing your symptoms, it is crucial to maintain a balanced diet, stay hydrated, and continue with probiotics if they have proven beneficial. Stress management techniques, such as mindfulness or cognitive behavioral therapy, may also help alleviate some of the gastrointestinal symptoms associated with anxiety or stress.

In summary, your gastrointestinal issues following heat stroke in the context of SLE may be attributed to a combination of stress, changes in gut microbiota, and potential sensitivity to medications. Continued monitoring of your symptoms, along with a collaborative approach with your healthcare providers, will be essential in managing your condition effectively. If symptoms persist or worsen, seeking a second opinion or further evaluation from a gastroenterologist may be warranted.

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