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Gastrointestinal Malfunction or Nervous System Response?

Looking for some insight on a tough medical problem! For reference, I've been to my general doctor, an OBGYN, and a gastroenterologist. I've been checked for every kind of allergy (seasonal and food), every cancer and precancer, and just recently endometriosis. I've had a laproscopy, colonoscopy, and endoscopy. Everything always comes back normal. I've tried every kind of ginger tea/drops, apple cider vinegar, probiotics, bacteria killing antibiotics, tums, pepto, zantac, imodium, even those seabands for pressure points, you name it, I've tried it. I don't drink or smoke, I incorporate meat (mostly white) into my daily diet and make sure to stay away from processed things like packaged goods, sodas, excessive gluten intake, sugar and have completely eliminated dairy. I exercise 30 mins a day around five times a week (if not more), typically a lower stress like yoga so I don't flare up my asthma.

I've always had ridiculously painful periods since I was 11, but at 15 I began to notice some gastro problems as well. Frequent nausea, feeling flushed before even a normal bm, going multiple times in a day, reflux, bloating, gas etc. The problems were made worse around periods so after being checked for allergies and having the colon and endoscopy, I had an unsuccessful battle with birth control pills for hormone regulation that only amplified my symptoms. After stopping that six months later, things were somewhat manageable. But now at 21, it's interfering with my daily life in a big way.

My biggest problem lately is urgent bms that come out of nowhere. Diet, exercise, sleep quality, and even the female calendar have no correlation (especially since I'm now on a hormone regulator that's supposed to put my body in a state of menopause). And when I mean urgent I mean URGENT. I get incredibly nauseated, pale and shaky, if I can't go right that second (it doesn't even have to be a diarrhea-like bm for me to experience this). This has led me to be quite a homebody which is hard since all my friends are out and about and I'm quite an extroverted A-type. Staying home 24/7 has "helped" the urgency factor but I still have the occasional flare up regardless of what I do that day. I will admit, there are times where I get apprehensive about going out unexpectedly considering I've had at least 3 bad experiences in the past six months where I had to go urgently and was in a spot where I couldn't (freeways aren't my friend in that situation!). I've wondered if this kind of makes things worse. For example today my mom told me we were going out to publix unexpectedly when I was having some cramps due to an oncoming bm. I was able to go (normally) before we left, and thought I was in the clear. Long story short, I ran into problems on the way to publix (went in publix), on the way home from publix (went again at the house), and about an hour later (went again) with each movement more painful (cramps wise) and looser. Could have potentially gone more but took an Imodium.

I'd like to know what's causing this, I can't just take Imodium every day.

Does this sound like a gastrointestinal problem or does it sound more nervous system related?

One last note:
Regardless of what I eat during the day, how much I eat, whether I eat or not before bed, and how much water I drink, I still get terrible bloating, reflux, and burping at night before even laying down. Usually kicks in around 9/10p when I'm still walking around and such. No idea why this is either!

Thanks for your input!
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Hello and welcome to the forum. Thanks for your question.  This sounds very stressful and like it is impacting your life in a negative way.  Very sorry to hear about that.  We encourage you to continue to work with your doctor.  I would think that this could indeed be related to endometriosis but another possibility is irritable bowel syndrome.  https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016  This article explains the disorder.  please know it can look different on a person to person basis.  How is your stress?  Would you say this factors in at all?  Now, they do need to make sure you do not have celiac disease or gluten intolerance.  The symptom you describe is common for that.  They need to rule that out.  But IBS is then diagnosed through exam, history and testing using specific criteria.  

Keep a food diary to see if certain foods trigger it at all.  You sound healthy!  You live a healthy lifestyle.  But still, track what you eat.  A doctor may recommend a host of things to do including medications specifically for IBS if you receive this diagnosis. Also remember that fiber can greatly help.  A probiotic may help with gut health.  

Let me know what you think.
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Hi! Thank you so much for your kind and helpful response!

I was so convinced I had endometriosis! Had most of the symptoms and risk factors, including an aunt that had it as well, but when I had the laparoscopy done in February of this year it came up completely normal! The pill I'm on now is supposed to be prescribed for women with endometriosis, but I haven't had much luck with it besides taking away my period. Everyone I've told seems uneasy about it since it's supposed to put my body in a state of menopause (I'm 21), and I've had all the symptoms/side effects except for hot flashing, but crazy nausea, irritability? Definitely. I just finished the third month, which should be the end of the side effects, but since they haven't I might give it another month or two to make sure they go away before I make any decisions on whether to get off or not. I just went through so much pain and sickness to adjust, it feels like such a waste.

As for IBS, my general doctor mentioned that it might be the case along with just being a "high functioning individual" when I was around 15 after all the scopes and tests came back clear but he didn't suggest much more than monitoring my trigger foods and staying away from sugar/processed things. I went to a Gastro doctor (referred by a friend who had a good experience) in December of last year but he made it sound like if the antibiotics didn't work (and they didn't--gave me terrible pain around my abdomen, my typical pain is in the range below the belly button and above the button of low rider jeans if that makes sense!),  then it wasn't a gasto problem and I should go back to the OBGYN. I appreciate the link you sent! I'll be sure to give it another look since it's been a while!

As for stress, I've been through it! Long story short I got my BSBA in 3 years and finished before turning 21 while managing my symptoms. I think a lot of people thought my symptoms would get better once I finished school and didn't have the stress, oddly enough I felt worse when I took a job that has me work mostly from home. Now I will admit, normal stress of deadlines and even conflict doesn't bother me, but traveling anywhere for long periods of time/not knowing where the bathroom is should I need it seems to make my symptoms as far as cramping, nausea, and bowel movements worse and maybe even bring on a flare-up. I think it's because I've been caught in situations where I couldn't go and it's just unsettling to think it might happen again. I guess another caveat is that since the virus happened I've had to stay home and not go out even more, and I still get flare-ups. Years before the virus I did try a dissolvable pill from my general doctor that was supposed to help the urgency factor, but either it just wasn't strong enough or wasn't what I needed since I still had flare-ups on it.

I have been checked for celiac and gluten intolerance (dairy too!) before and everything came back fine! I even tried going off gluten (and being vigilant about cross-contamination), but I didn't notice much of a difference, staying away from dairy was really the only noticeable difference. Also to your point of a food diary, I just downloaded an app to help track everything (it's called mySymptoms!) and it lets me put in foods, symptoms, bathroom breaks, etc. and it'll prepare a sheet that you can show your doctor! I'm pretty good at being organized/diligent, so I think I can stay on top of it!

I've tried fiber in various forms before with weird results! I've heard it's supposed to regulate, but it just made me go so uncomfortably and frequently, honestly, it was the same reaction I get to foods that don't go over well (like dairy and almonds). Probiotics are weird too but for a different reason! I've tried moderate to low end ones at the drugstore to ones you have to buy off the internet! For some reason, it makes me terribly constipated and traps everything in making me feel worse (I've had so many people tell me this is an odd reaction before but I really can't explain it! My grandma has the same reaction to them but she doesn't have the same stomach problems) but at the same time, if I have a flare-up taking a probiotic doesn't stop it from continuing. Just weird!  I tried flaxseed too for a bit but didn't notice a difference and just kind of stopped taking it.

I'm thinking my next step would be to go to a nutritionist? Maybe they can run some tests and see specifics on what I'm lacking in my diet? I'm not really sure what else to do!

I'm sorry this is so long! I almost wonder if it's helpful or I'm just venting at this point lol!

Thank you again for responding to my original post! I really do appreciate it! Even if someone says they're just as confused as I am, it's nice to know I'm not alone!
I give you kudos for being on top of your health.  The diet diary is great and should be insightful. I understand your fears about medication as well.  What drug is it that they are suggesting?  A nutritionist is fantastic and please let me know if you see one.  Keep me updated!
Hi again!

The pill was called Jintili (or something like that?) and I don't remember the name of the antibiotic (something with an A?) but it was for SIBO and I do remember it had commercials on TV at one point.

A little update! I read into the link you sent and decided to give IBS another look! I decided to download an app that scans barcodes for FODMAPs and gives it a red/yellow/green rating for the likelihood of upsetting your stomach, just for the heck of it! I kid you not I didn't get one green level food for the entire day! All my "healthy" choices like a green smoothie, apples, mangos, and peppers, everything was a yellow or red! It's quite restrictive (as I'm sure you know!) but I'm preparing to crossover to a Low FODMAP diet to figure out the real irritants!

I also found that doing a nightly yoga routine (as opposed to my normal morning/afternoon yoga) for IBS hasn't cured my symptoms but has really helped some of the bloating!

Thank you again for reaching out to me!
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