• 27 days ago

    Exocrine Pancreatic Insufficiency vs IBS

    Hello all
    I have developed increasingly severe symptoms, I have had Lactose intolerance for years I take Lactase for that. In past year I have had increasing symptoms rapid elimination of just about any food, oily odorific Steatorrhea, frequent gas pain and acid indigestion, have repeatedly Negative Stool guaiac fecal occult blood test (gFOBT)tests, Very abnormally low blood Ferritin levels repeatedly ranging 15 to 17 but with concurrent Normal Iron, Total Iron Binding Capacity (TIBC), Transferrin Level & Iron Saturation levels normal, B12 Folate levels are normal, Thyroid Tests all normal repeatedly. Generally normal Hematology rbc counts, Hemoglobin & Hematocrit, no erythrocyte Microcytosis or Macrocytosis or abnormal morphology. Sometimes H&H are a bit low due to a chronic pre-Waldstroms MGUS. Daily Symptoms: Fatigue, Tiredness, multiple bowel movements (5 to 8) rapid urgent need to bowel movements almost immediately after eating. Taking one tablet 333 mg Iron/daily and 1/2 to 1 10mg tablet Loratadine daily & when needed 2 tablets. Taking a slew of vitamins daily carefully chosen so that none are in excess of recommended doses. Age 65 male semi-Pre Diabetic type II since Acute Renal failure due to spider venom with resultant MCD Nephrotic syndrome cured by 6 months treatment 80 mg/day Prednisone in 2012, no family history of diabetes. Having lost excess weight (aka prednisone ravenous hunger syndrome caused) blood sugars while on 80mg prednisone were 700 mg./dl range treated with insulin then switched to Glyburide after prednisone stopped for next 1.5 years. Then as glucose levels were too low no longer on Glyburide
    glucose levels now normal 99% of time with HgB A1C's ranging 7.0 to 7.6. Was due to have virtual CT Colonoscopy (best for IBS dx) but health insurance was cancelled 3X now and now the Gastroenterologist has retired, have appointment with new Gastroenterologist in 3 weeks. Also post prednisone 80 mg/day 6 months now have a "Fatty liver" all LFT tests are normal, negative Hepatitis A, B, C tests including DNA probes tests, HIV negative, non-alcoholic or drug user ever in past nor at present. Have abnormal Abdominal CT results 10+ years 300+ lymphoid masses 1-2.5cm each in Mesentery and elsewhere- secondary B-cell lymphoma to pre-Waldstroms Macroglobulinemia MGUS, IgM = 5X higher than normal (10x higher than normal kappa free light chain) , IgG abnormal low 1/3rd of normal, IgA almost non-existent. Low ferritin level may be due to IBS? or decreased production -fatty liver disease? or possible low level autoimmune hemolytic anemia, typically low HgB 12.7g/L, HCT 38%, RBC 3.89M-uL when not on Testosterone gel replacement treatment whereas, when on Testosterone HgB and HCT all results become normal levels. Have other autoimmune conditions: Allergic Asthma, Osteoarthritis, Psoriasis, possible Psoriatic arthritis which may suggest higher possibility of IBS and chronic autoimmune hemolytic anemia. Blood type A Rh- negative Du Negative
    Also have Osteoporosis and Spinal stenosis. Have tried elimination diet, found that tomato sauce sadly is a major cause a symptoms, but so is broccoli, peppers, and any greasy meats like sausage, bacon, pepperoni, salami. Still have my appendix and gall bladder, did have 1 gall a bad gall bladder attack in 2010 have cut down to low fat diet & no fried foods since, I take 2 grams vitamin C/day (helps dissolve gallstones) as result I have dissolved 2 of 3 gallstones 1 more to go. I wanted to avoid surgical option as IgG is very low but if needed I will special request IVIG. Not sure about Crohn's or Ulcerative colitis no positive occult blood, will request stool elastin and total fat tests soon. Would be very interested in your opinions, recommendations thank you.