Recent Extreme Fatique, is this normal?

[amerrigan]

Hi all,
Currently awaiting my first GI appointment (next Tuesday), getting scared (but looking forward to actually moving forward at last).

I pretty much have lower right pain all the time (it's like a scratching/graze not too painful) occasional pain under Ribs, usually accompanied by bloating in the same area. Had ultrasound for gallstones, blood tests, stool tests for all the usuals (I'm sure); results are always "normal". Diahorea is normal for me, very occasional blood (but have been told not to worry as it's most likely piles) due to amount and brightness of it.

It started off as bloating and changes in bowel habits, moving on to pain under ribs and slight bloating in lower right (which I put down to the seat belt in the car rubbing).

Recently had the fecal occult tests and been told I have a possible IBD as my calprotectin was higher than it should be (57/50) but having some worrying symptoms the last two weeks which are out of the norm for me which has even taken me to A&E (ER) in the panic.

So about a week ago (last Monday) I had really bad diahorea (food poisoning possible on top of usuals) and feeling like I'm going to be sick. Tuesday last week on the way home from work I felt unwell whilst driving (almost feinted) followed by mild fatique. Wednesday I took off work, as I had Flu like symptoms (but no fever) - Tues/Wed no bowel movement, no gas. Thursday absolutely fine, felt normal (ignoring the usual abdo pains) went into work. Friday felt fine until about midday, then felt very fatiqued (7/10) so went to Doc's (more blood tests on Monday). Saturday slightly fatiqued (4/10), Sunday bad (8/10), pretty much laid on the sofa all day. Monday blood tests come and go and by lunch time, feeling horrible (9/10) so get sent to A&E by my boss, 5 hours later told bloods are normal go home... Ironically an hour later I felt ok... Fine yesterday, slight fatique immediately after big lunch; today felt good with a slight fatique dip before lunch and again just now before dinner.

The fatique is very worrying as it suddenly "Switchs on", has anyone gone through similar in the lead up to diagnosis and treatment? Is this kind of fatique normal for IBD?

 

[nogutsnoglory]

Fatigue can be symptomatic of many conditions but certainly IBD too. The most important part is a correct diagnosis but blood tests checking thyroid, b12, iron and Adrenal levels are important in seeing if there is a nutritional deficiency causing it.

 

[amerrigan]

Blood tests are all normal, had full bloods done again on Monday.

 

[nogutsnoglory]

Have you had CRP and ESR inflammatory markers? An underlying disease that your body is fighting could also lead to fatigue.

 

[DEmberton]

What constitutes "normal" is open to some debate. I've always had fatigue that comes on very suddenly; I've read that it's a B12 sign specifically, but not sure if that's true. The level that the NHS consider low is much lower than a lot of the experts say it should be. I've found it's hard to get doctors to tell you the numbers, but they should if you ask.

It's possible if you're getting a lot of diarrhoea that you're losing minerals and vitamins that your body should be absorbing, and that will contribute to tiredness. Make sure you drink lots of water too - dehydration can certainly make you tired.

I spent a lot of weekends lying on the sofa feeling too tired to do anything, so yes it is part of IBD if that's what you have. Don't fear the GI ;-). Most likely they'll want to give you a colonoscopy (don't fear that either).

 

[amerrigan]

Thanks, it's the sudden onset of fatigue that's worrying (and the relative newness of it); it's like a switch being turned on (or off) rather than a gradual thing.

My younger sister is receiving B12 injections currently and the other one had her gallbladder removed recently).

Anyone know how long the avg UK waiting list for colonoscopy is, if GI requests it?

 

[DEmberton]

Does your sister know why she needs B12 injections? Genetics is a factor in IBD and Pernicious Anemia. BTW your lower right is where you find the Terminal Ileum, which is the last part of the small bowel and the most likely place for Crohn's. It's also where B12 is absorbed. That's exactly what I had, but don't jump to any conclusions, your case may be different.

A year or so ago I was told 6 weeks for a colonoscopy, but they actually did it in two thanks to a cancellation. But it took them another 6 months to figure out what was going on. Very frustrating, but unfortunately you need to go through the process.

 

[StarGirrrrl]

It varies from Hospital to Hospital I am afraid, there is no UK standard. I got in for a fairly high, although not highest priority scope within 15 days (offered an appointment in 10!) but in other parts of the UK that same priority would see someone wait several months.

 

[UnXmas]

There are a huge number of possible causes of your symptoms besides IBD, for both the digestive symptoms and the fatigue. The specifics of your symptoms (where you feel pain, how fast fatigue comes on) don't really point towards IBD, because IBD symptoms vary a lot from person to person, and fatigue, diarrhoea and pain are very general symptoms. Passing blood has fewer causes, however. Have you had a rectal exam to confirm haemorrhoids? That's a simple test a GP can do. What caused your sisters' problems? A family history of IBD would make it more likely that that could be what you have.

Waiting times vary depending mainly on the urgency of the need for the tests, but also varying from one hospital to another. For a non-urgent test, you'll probably wait a few weeks to several weeks.

When I had a faecal calprotectin test, the results must have been in a different form - I seem to remember the number was in the 1000s. Sorry, that probably just confused you more!

What symptoms took you to A&E? Did they do anything other than blood tests (abdominal exam, rectal exam, blood pressure, temperature)?

Diagnosis can be complicated: the most important thing is to find doctors you trust - a GP and a gastroenterologist. Make sure your doctors understand your concerns, and if you're waiting a while for a diagnosis, ask about symptom management in the mean time. There are meds that can help with pain relief and diarrhoea, even if they haven't yet found the underlying cause to treat. And do take care if you're driving - if fatigue or pain come on when you're driving, stop. It's not worth taking risks.

I hope you get some answers and treatment very soon.

 

[amerrigan]

Firstly thanks all to those who have commented, I appreciate the help and your time. So it's now a month on or so since I last posted:

I've now seen the GI (well the registrar) and he's referred me for a non-urgent Colonoscopy and MRI to check things down below. "Bum camera" is only two weeks away now.

The fatique has pretty much gone now, I changed to a low fat diet last week (as Sunday dinner didn't agree), it was kind of of weird as I laying on my back Monday in intense pain (under right rib) and suddendly boom pain goes and so does the fatique...

Still random days in pain, kind of a burning/scraping pain up and down my right side as I write this; but hey I can live with pain it's the weirdnesses that are terrifying.