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Why Do I Have Sharp Stabbing/gnawing Abdominal Pain?
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Hello everybody, This is my first post since I have been diagnosed with Celiac Disease early July of 2013. My symptoms started about 2.5 years ago with carpal tunnel like symptoms in both hands in which all tests and treatments for the 'carpal tunnel' were negative and/or unsuccessful. My abdominal pain started May 28th 2013 around 10pm, the pain was severe burning in my abdomen that kept me up until 7am. The following morning I ran out and started taking omeprazole x2 per day along with 150mg ratitidine (zantac) once per day. For two weeks it seemed to help but my appetite was way down. Within two days of stopping the omeprazole (prilosec) the abdominal pain started again. I followed up with a GI who performed an Endoscopy expecting to find evidence of GERD and the report was as follows:



*** ADDENDUM REPORT ***
This report contains an addendum to the original report for the purpose of
providing additional information. The original diagnosis remains unchanged.


H. pylori immunostain is negative.

DIAGNOSIS:

A. Proximal esophagus, biopsy:
Squamous mucosa with no diagnostic abnormalities identified.

B. Distal esophagus, biopsy:
Squamous mucosa with no diagnostic abnormalities identified.

C. Antrum, biopsy:
Chronic active gastritis, (see note).

D. First portion duodenum, biopsy:
Chronic duodenitis with moderate villous blunting, lamina propria
lymphoplasmacytosis and surface lymphocytosis, (see note).

E. Second and third part duodenum, biopsy:
Mild chronic duodenitis with partial villous blunting, lamina propria
lymphoplasmacytosis and patchy surface lymphocytosis, (see note).

NOTE: The duodenal findings, especially the first portion, are consistent with
celiac sprue in the appropriate clinical setting. Results of an
immunostain for H. pylori will be reported upon completion in an addendum.

Clinical diagnosis & history:

Dyspepsia; epigastric pain; reflux symptoms; postprandial abdominal pain;
findings: grade B esophagitis in the lower third of the esophagus and middle
third of the esophagus (biopsy); the Z-line was regular; erythema in the antrum
(biopsy); normal mucosa in the stomach body, fundus and cardia; slight
scalloping of folds in the first part of the duodenum (biopsy); normal mucosa
in the second part of the duodenum and third part of the duodenum (biopsy);
esophagitis unspecified, 530.10; reflux esophagitis, 530.11
 
After being strictly gluten free and I mean seriously a freak about it (pots, pans, wont eat out, toaster, microwave) you name it I don't share it or eat it. I still have stabbing, and this gnawing, burning, twisting like pain in my abdomen. I followed up with a new GI in Boston who performed a repeat colon/edoscopy and the only thing found again was, "chronic active gastritis with intestinal metaplasia" and no evidence of Celiac Disease, which my PCP suspects its from the gluten free diet. Basically I'm freaking out because I don't know what to do about it. I lost my job as a full time firefighter late last year at the age of 23 due to this stupid issue. I know this may seem like the typical sob story but I was hoping some one may have some advice? or maybe have a similar issue? Can gastritis (MILD) really cause this much pain? I don't have any parasites, h. pylori, SIBO, yersinia, Etc.. all that confirmed by stool testing and their associated tests. 
 
Sorry for the long post.. I would post the second colon/EDG report but like I said other than those two findings (Normal duodenum and the metaplasia) everything else was normal.
 
- Greg 

 

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i hope you are not having additional problems, but for what it's worth, i had (hard to describe it) sort of like 'scraping' pain, like some things i would eat were being dragged over my intestines and it hurt.  i kept a food journal, and it was certain things that were bothering it:  peppers, some types of raw veggies, - things that were gluten free, but i suppose they were irritating my guts where i still had damage.  i eliminated them for a while and now everything seems to be ok.  a little hard to wrap my head around at first because i was confused:  i *should* be able to eat this or that with no problem because it's gluten free.  not so, when your intestines are likely to be inflamed or irritated by what you're eating.  nothing to do with gluten but i stopped eating some things for awhile just to let my guts heal.  good luck and hope you feel better :)

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Hi Greg and Welcome to the Forum!

 

The good news is that your strict gluten-free diet seems to have elimated the evidence of Celiac from your gut - so good job on that one!  Otherwise, I agree with Arlene - try eating easily-digested foods and keep a food journal.  Your body may just not be able to handle certain foods yet, or you may have other food intolerances (i.e. dairy, corn, soy, nightshades - these are common ones).

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Hi Greg,

 

I have the gnawing symptoms like you and they drive me nuts. Out of all of my Celiac symptoms, that is the one that effects my quality of life the most. I can totally see how it would have effected you so much that you lost your job. It is a very draining type of pain and can wear a person down quickly. Mine can range from a mild gnawing hunger type pain, to a more intense feeling that I describe as feeling like someone is slowly rubbing a cheese grater up and down inside my stomach, to the most intense pain that I would describe as feeling like a mouse is trying to gnaw and scratch it's way out of my stomach. I know that's a really strange way to describe it, but that's what it feels like! Is your pain similar?

 

I notice that you mention that you have gastritis, I have GERD and I too am wondering if maybe it is what's causing the gnawing pain. I have definitely been able to identify some triggers foods, so these are mine and might be some for you to watch out for: coffee, tea, carbonated beverages, milk, ice cream, too much cheese at once, broccoli and tomatoes. Have you noticed that any foods or beverages make your pain worse? Dairy is a real problem for a lot of people with Celiac Disease and is one you should watch our for. One of the hardest parts of these types of issues is trying to figure out the exact problem! Something that helps a little is if I take a dose of liquid antacid. It seems to coat the stomach and make it feel a little better. I am on Prilosec long term too, to try to help the problem. I couldn't tell from your post if you are still taking Prilosec, but it doesn't really keep the gnawing away for me.

 

I have to say, Congratulations that there was no evidence of Celiac Disease when you had your endoscopy!! That's fantastic and I hope you will feel better soon.

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I agree with everyone!  Most of my intolerances /allergies were identified long before my diagnosis.  Since going gluten free for almost a year, my intolerances/allergies have not gone away (milk, nuts, garlic, eggs).  Now, I have developed a few new ones (xanthan gum found in lots of processed gluten free foods) and pumpkin seeds.  Will it never end?

 

Keep the journal.  Rotate your foods around a bit.  Often it's a food that you eat day-in and day-out.  

 

Have you had a HIDA scan on your gallbladder?  It's a curse in our family.  No stones, but non-functioning and it hits all ages.

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Hi Greg,

 

I can't eat many of your list of foods - probably 2/3 of them, including cinnamon, which seems like a weird one.  i also can't eat oregano, basil or mint.  i went gluten-free for 8 month - also fanatically so - and saw zero difference.  I use Enzymedic Digest every time i eat - you can find it online or i buy it in a local co-op type store.  i take probiotics and lactase enzymes.  Those help me tremendously.

 

http://www.vitaminshoppe.com/p/enzymedica-digest-90-capsules/kt-1004?sourceType=sc&source=FG&adGroup=40-60&keyword=KT-1004&cm_mmc=Google+Shopping-_-Product+Listing+Ads-_-40-60-_-KT-1004&gclid=CJKc75fg6LwCFUNffgod1kQA1A&gclsrc=aw.ds (I don't buy from them, but this is the brand.  There is a weaker version, Digest Basic and a stronger one, Digest Gold)

 

http://www.digestiveadvantage.com/digestive-advantage-lactose-defense-formula-32-count (I take 1-2 of these daily and they help with any lactose you encounter - i would take a probiotic if i wanted to eat ice cream, but for things like sauces these work for me.)

 

There was a study done - can't lay my hands on it now - which said that Align is the probiotic that is most helpful to people with IBS.  

 

I recently went to a gastroenterologist who said if a food bothers me don't eat it.  that was very helpful, as you can imagine.  It made me furious.  My daughter had discovered a naturopathic doctor and was seeing her (in another city) for the same kind of problems.  I made an appt with her and have just finished testing for a couple of things.  Don't have the results yet.

 

one is for the MTHFR genetic mutations: http://mthfr.net/  This is apparently a common mutation and it has extensive implications in the body.  I read through this and thought it described many of my issues and those of my family members.  Look carefully at that site, because if you have the genetic mutation it keeps you from being able to "methylate" folate, which affects everything.  

The second testing I did was for SIBO.  You mention it above, but i'm unclear if you had a stool test done that looked for it or if you did the breath testing.  My understanding (i'm not an expert) is that the breath testing is the appropriate way to test for it.  Here is an excellent site with a lot of good information:  http://www.siboinfo.com/  If you haven't done the breath test, you might try it.

 

If you're not using digestive enzymes when you eat, that would be a great first step.  I don't think they can hurt and they may help.

 

I have taken Betaine HCL which increases the amount of acid in your stomach in order to break down food.  I prefer the digestive enzymes, but last night i read a site about how we tend to need more acid in our stomachs and not less.  I wasn't familiar with the site and don't know how accurate it is, but someone passed it on to me.  fwiw:  http://balancedbites.com/2012/01/why-you-want-more-stomach-acid-not-less.html

 

I don't think the pills i've mentioned above substitute for figuring out a cause if possible, but in the meantime they may get you out of pain and help you process the food you are eating.  I have felt like the digestive enzymes have literally kept me alive for the past 15 years.  i have had chronic diarrhea after eating for about 40 years.  not a good time.  

Good luck to you!  Your situation sounds dire and i hope you can get some help.  If you can't get help from the gastroenterologists, i wouldn't hesitate to try a naturopathic doctor.

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Hi Greg,

 

Have you been tested for food allergies?  I don't think it is super reliable testing really, but might show up something.

 

I don't think you listed what foods you are eating?  It's best to stick to a very simple whole foods diet when troubleshooting food issues.  Things like  meats, veggies, fruit, nuts.  Single ingredient foods are easier to figure out if they are causing a problem.  Mainly because your meals end up having very few ingredients in total.

 

You could try an elimination diet.  Start with 5 simple. whole foods only.  You need to give it little while at the beginning for things to settle down.  Then after a 2 week settling in period add one new food each week.  Boring diet, but if a food is the problem you should be able to detect a reaction when it is added in.

 

If you are taking vitamins or meds they need to be eliminated also, just like foods.  Everything is  a possible problem, including drinks (coffee, tea, alcohol, soda).

 

I don't know if you are eating oats, but some of us have problems with them.  Nightshades are potatoes, peppers, tomatoes, and eggplant.  Sweet potatoes are not nightshades, they are a different plant family.

 

You could also try some mastic gum and DGL.  They both treat h. pylori but probably help with other bacteria too.

 

Pepto Bismol may help releive stomach pain temporarily.

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Hi Greg,

 

I can't eat many of your list of foods - probably 2/3 of them, including cinnamon, which seems like a weird one.  i also can't eat oregano, basil or mint.  i went gluten-free for 8 month - also fanatically so - and saw zero difference.  I use Enzymedic Digest every time i eat - you can find it online or i buy it in a local co-op type store.  i take probiotics and lactase enzymes.  Those help me tremendously.

 

http://www.vitaminshoppe.com/p/enzymedica-digest-90-capsules/kt-1004?sourceType=sc&source=FG&adGroup=40-60&keyword=KT-1004&cm_mmc=Google+Shopping-_-Product+Listing+Ads-_-40-60-_-KT-1004&gclid=CJKc75fg6LwCFUNffgod1kQA1A&gclsrc=aw.ds (I don't buy from them, but this is the brand.  There is a weaker version, Digest Basic and a stronger one, Digest Gold)

 

http://www.digestiveadvantage.com/digestive-advantage-lactose-defense-formula-32-count (I take 1-2 of these daily and they help with any lactose you encounter - i would take a probiotic if i wanted to eat ice cream, but for things like sauces these work for me.)

 

There was a study done - can't lay my hands on it now - which said that Align is the probiotic that is most helpful to people with IBS.  

 

I recently went to a gastroenterologist who said if a food bothers me don't eat it.  that was very helpful, as you can imagine.  It made me furious.  My daughter had discovered a naturopathic doctor and was seeing her (in another city) for the same kind of problems.  I made an appt with her and have just finished testing for a couple of things.  Don't have the results yet.

 

one is for the MTHFR genetic mutations: http://mthfr.net/  This is apparently a common mutation and it has extensive implications in the body.  I read through this and thought it described many of my issues and those of my family members.  Look carefully at that site, because if you have the genetic mutation it keeps you from being able to "methylate" folate, which affects everything.  

The second testing I did was for SIBO.  You mention it above, but i'm unclear if you had a stool test done that looked for it or if you did the breath testing.  My understanding (i'm not an expert) is that the breath testing is the appropriate way to test for it.  Here is an excellent site with a lot of good information:  http://www.siboinfo.com/  If you haven't done the breath test, you might try it.

 

If you're not using digestive enzymes when you eat, that would be a great first step.  I don't think they can hurt and they may help.

 

I have taken Betaine HCL which increases the amount of acid in your stomach in order to break down food.  I prefer the digestive enzymes, but last night i read a site about how we tend to need more acid in our stomachs and not less.  I wasn't familiar with the site and don't know how accurate it is, but someone passed it on to me.  fwiw:  http://balancedbites.com/2012/01/why-you-want-more-stomach-acid-not-less.html

 

I don't think the pills i've mentioned above substitute for figuring out a cause if possible, but in the meantime they may get you out of pain and help you process the food you are eating.  I have felt like the digestive enzymes have literally kept me alive for the past 15 years.  i have had chronic diarrhea after eating for about 40 years.  not a good time.  

Good luck to you!  Your situation sounds dire and i hope you can get some help.  If you can't get help from the gastroenterologists, i wouldn't hesitate to try a naturopathic doctor.

 

I suffered several nights of agony with stabbing and burning pains. My endoscopy showed only mild gastritis, H. Pylori negative. But the doctor insisted I try that purple pill. I took it for a week, it helped a bit, but then I quit taking it because I was concerned that the acid reduction would do more harm than good. The GI never said I had GERD, oddly.

 

My theory was the culprit was a gluten free brownie mix. I am not sure what part of it triggered the pains, maybe it wasn't even really gluten free? I've had chocolate since, but no pain. I'm baffled, but hoping I never go through it again!

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I also have/had mild gastritis (it showed up on my endoscopy a year and a half ago after experiencing just such a pain). It still flares up on occasion. On top of Celiac, I'm also intolerant to dairy and soy, can't handle eggs on their own, avoid whole quinoa (that cause the horrid pain the first place), and random things that should be good for you (whole-grain/brown rice, beans, etc) my gut just doesn't want to deal with.

A food diary is a good idea, to see if there's anything you're eating that might be causing the pain. Whole/simple foods might help, not too much caffein or alcohol. It takes time to figure out what makes your gut unhappy, and it does seem like a never ending battle, but it does get better.

 

Digestive enzymes and probiotics can also help.

 

Good luck!

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I have been diagnosed since november 2013 and gluten free since. Felt better immediately. Other then an upper right pain under my ribs that had started it all back in January 2013. My issue is just about everything I eat gives me severe intestinal pain. Three weeks now about every other day pain is terrible. Afraid to eat at all. Lying down or moving around feels the best. Any thoughts? I don't eat dairy and found that corn doesn't agree with me.

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I have been diagnosed since november 2013 and gluten free since. Felt better immediately. Other then an upper right pain under my ribs that had started it all back in January 2013. My issue is just about everything I eat gives me severe intestinal pain. Three weeks now about every other day pain is terrible. Afraid to eat at all. Lying down or moving around feels the best. Any thoughts? I don't eat dairy and found that corn doesn't agree with me.

 

Hi JTS and Welcome to the Forum!

 

(If you don't get many direct responses to your question, you may want to try starting your own thread - even though your question is closely related to the OP's.)

 

That said, it sounds like you may have other food intolerances going on - you already mentioned corn.  Are you sure you have gotten all of the corn out of your diet?  Corn hides and lurks in foods worse than gluten does.  You may want to keep a food journal to see if you can figure out what is triggering your symptoms.  If that doesn't work, you may also want to try an elimination diet to see what other foods you may be having an issue with.  It seems relatively common for Celiacs to have issues with other foods at first.  Some foods they're able to reintroduce into their diet over time, others require a life-long avoidance.

 

Keep in mind you're still new at this too - your body is still healing and is likely to be more sensitive than it will get to be over time.

 

Good luck!

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I have been diagnosed since november 2013 and gluten free since. Felt better immediately. Other then an upper right pain under my ribs that had started it all back in January 2013. My issue is just about everything I eat gives me severe intestinal pain. Three weeks now about every other day pain is terrible. Afraid to eat at all. Lying down or moving around feels the best. Any thoughts? I don't eat dairy and found that corn doesn't agree with me.

How is your gallbladder?

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I had a gallbladder scan done over a year ago.It came back fine.I was into lifting weights heavily last 10 years. My first thoughts was I might have injured myself doing so. Talking to a Dr he stated that if I had there was no fix for that specific area. So I eased up a bit and then the foggy head, intestinal burning and bloating started. Never got a fever since the pain started. Not sure what that pain is. When I get bloated and burning in intestines the pain goes away.

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I have a GI appt in a couple of weeks, to deal with much of the same thing.  I am still suffering Esophagitis issues, but no reflux.  Serious heartattack type pain in the chest, nausea, wheezing, coughing, and constant clearing of the throat etc.  No acid issues though, no reflux, I do not understand it.  So, off I go to see what he says.  Could grade 2 have gotten worse?  I have been very strict about my diet.  We only go out to dinner once or twice a month now.  I am a former chocaholic who had to cut that back almost non existent and I gave away my espresso machine.  I have been serious about this.

 

If anyone has advice or words of support I would love to hear them.

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You can try some natural treatments for h. pylori.  If they help, then it is probably and h. pylori infection causing the pain..  Some that may help are mastic gum, and DGL.  I suggest taking both at once.  If they don't help after a week, then it may be something else causing the pain.  H pylori is a problem sometimes when people are taking antacids too often.

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No antacids.  I have not been taking the prescribed antacids, instead I took the natural route and have kept it under control, until around Thanksgiving.  Yes, its possible I was glutened at a relatives house, or yes, its possible I have overrun in bacteria again due to sugar at Christmas, but its March now, and I have been diligent since January 1.  I only allowed sugar, baking for the kids, to enter the the diet, and we did go to a relatives at Thanksgiving, she tried to accommodate, but we all know how that goes.

 

I will try your suggestion H-P would make sense if sugar was a culprit.  Thank you.

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ACV too.  Much better, I still have some of the problems but not as bad as it was.  Still going to the doctor in 2 weeks.  It takes a long time to get into see the GI here.

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