Do IBD and acute gastritis affect my weight gain?

Question

Hello doctor,

Recently, I have been having problems with my intestines and digestion. I visited a doctor who said it was irritable bowel syndrome (IBS), but no tests were done to determine the cause. I have endometriosis and had a cyst on my left ovary for three years, which caused frequent severe pain.

Over the years, I have taken painkillers regularly, including paracetamol and Aulin. My Paracetamol intake was around seven pills of 500 mg per day for four days every month and occasionally five pills due to other reasons. While taking Paracetamol, I often felt unwell, lost my appetite, and experienced poor digestion. I drank artichoke tea during these episodes, which provided temporary relief.

I have also had acute gastritis during illnesses. Recently, these symptoms have worsened, and I now have abdominal pain. For the past four years, I have had excessive gas, which has increased, and I do not know why.

My intestines make loud gurgling noises, especially when I lie on my left side. I do not believe the IBS is caused by stress or emotions if that diagnosis is correct. My abdominal organs were checked via ultrasound, and no issues were found.

Over the past year, I have developed constipation, and every four months, I experience unexplained severe pain on my right side. This has been happening for six years. I initially thought it was a kidney issue, but no kidney problems were detected, apart from E. coli, which I have had for the past two years.

I have difficulty gaining weight and lose it very easily, even though I eat a normal amount, including unhealthy foods. While this may sound like a good thing to some, everyone tells me I am too thin.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed your case history in detail. I agree that IBS (inflammatory bowel syndrome) is a diagnosis of exclusion. Once you have ruled out all other possible causes, you can label it IBS.

In your case, endometriosis (a chronic medical condition in which tissue similar to the lining of the uterus) is one of the possibilities of pain, especially during your periods. However, it does not cause gut-related symptoms if there is no involvement of the gut (that means endometriosis deposits on the gut itself or the abdominal internal membrane known as mesentery).

You are taking too many painkillers, including Paracetamol and others, which can explain your drug-induced gastritis and loss of appetite. It can cause nausea and upper abdominal pain, too.

Regarding your gut disturbances, I would think of bacterial imbalance known as dysbiosis, which is very common if there is a history of eating out, taking painkillers, and much more. I would suggest avoiding eating out for a couple of days and taking only fresh meals at home.

Taking a tablet of Pantoprazole 40 mg half an hour before breakfast is acid-suppressing medicine, and it will help your stomach. You can take it regularly for about two weeks.

Regarding your gut issues, add probiotics, daily yogurt, and commercially available good probiotics once daily for about one to two weeks. Avoid unnecessary painkillers, and if the pain is severe, visit a gynecologist and discuss other possible options for endometriosis.

Increase water intake, regular Isabgol husk, and even occasionally laxatives like sodium pico sulfate in case of severe constipation. If you are not losing weight, that is fine. For weight gain, you should be seen in a clinic (detailed history and physical examination).

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

Yes, you can go for baseline investigations like a complete blood profile, liver function tests, and an ultrasound of the abdomen. I do not think parasites at your age, especially if you are drinking boiled or filtered water and eating hygienic food.

Liver disease usually does not cause episodic abdominal pain or disturbance in bowel habits, but causes jaundice, nausea, vomiting, dark urine, etc.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.