Stomach, Gastrointestinal Problems with Type 1

Type 1 and LADA
1

Hi,

My daughter is now 16, has had Type 1 for 2 years & really hasn't had problems eating ANYTHING until the last few weeks. She's had alternating constipation & diarrhea, fatigue, vomiting, stomach pain, feeling full, bloating & blood sugar handing around 230. I think that covers the symptoms. We've been to her general doctor & she said try probiotics & Zantac, since we've already tried Pepto, Alka Seltzer, etc. The doc also ran the blood test for Celiac, which came back negative. She missed school all last week & missed her softball games --she's a junior in high school & we're working on college recruiting, so this is important. We're seeing her endo on May 21. She also has hypothyroidism, if that has any effect on this.

I'm wondering if I should go ahead & call a gastroenterologist. I'm thinking she's going to need a bunch of tests to figure this out. I know gastroparesis is a possibility -- but is this a little early on for her to have that problem? Also, any diet suggestions would help. She does ok with scrambled eggs for breakfast. She threw up after eating cantaloupe. She felt full after a few spoonfuls of mac & cheese. The doc also told us to keep a food diary. I just need to help her finish the last few weeks of school while we figure this out!

2

I think a gastro might be the way to go. Honestly, it does sound like Celiac disease. And the blood tests can come back negative for years with symptoms. If the blood test comes back negative, especially with Celiac symptoms and a history of autoimmune disease, they'll do an endoscopy, anyway.

Though I definitely agree that keeping a food diary is a good idea in case it isn't Celiac, keep in mind that if it is, the foods she "reacts" to may be gluten free. The reason for this is that the body needs time to heal after being exposed to gluten. I have a neighbor who's gotten sick for days from one cross-contaminated food item! Therefore, if she does have Celiac and isn't off gluten yet, I wouldn't be surprised that she's bothered by other things.

I wish you lots of luck and I hope she feels better soon!

3

While GP is a possibility, as you said at this point that seems unlikely. It could be gallbladder,H. pylori, celiac, addison or possibly something else. I would get an appointment with the gastro ASAP. If symptoms persist and it's taking forever to get an appointment with the gastro, you could jumpstart things by taking her to the ER. You'll get it figured out.

4

I'd try avoiding all gluten to see if that helps. Blood test for celiac isn't accurate. Gluten is in many things, so it takes a careful eye.

It could be gastroparesis. I was diagnosed with gastroparesis shortly after diabetes diagnosis.

5

Thanks -- I didn't know the blood test wasn't accurate. We've been trying to avoid gluten this week, but I don't really know what I'm doing. I thought maybe it could be gastroparesis -- You've made up my mind, I'm going to call a gastro doc tomorrow & try to get an appt. I almost took her to the ER on Friday because I was thinking that would jump-start some tests & she felt awful & we couldn't get her blood sugar under control, but then suddenly we got her back around 100 & she felt slightly better. If we can be very careful about what she eats, we may be able to make it to an appointment.

6

Thanks!!

7

I'm so sorry to hear about your daughter. if blood sugars are high, it effects all parts of our bodies (every nerve, organ, muscle, cell, etc..), our stomach, gastro, in particular, lots of nerves, etc...Yes, see a GI specialist, please. I doubt it's celiac, this gluten- free thing is rather a trend now. If she has celiacs she'd test positive. it could just be diabetic stomach problems, I've had them too. I'm seeing a GI doc. I've had nothing but problems. I'm very surprised her GP didn't refer her to a GI specialist...stomach problems are top of the list for Type 1's. Good luck! :)Also, is she on a pump or MDI, what insulin(s) is she using? Is she on symlin? Doesn't that cause GI issues?

8

My most telling gastroparesis symptom was lows after eating & highs many hours later when insulin was gone. I didn't bother with a stomach emptying study because it was obvious. The most difficult time for me is after dinner & testing isn't done then, of course.

Dosing insulin with gastroparesis is challenging when digestion is not predictable. I take a small bolus after eating & a larger dose hours later. There are some dietary adjustments that help some.

9

I would go to the gastroenterologist. That is the ONLY definitive way to rule out Celiac. But, also keep in mind there are a lot of viral type infections that can mimic signs like this too. I used to work in gastro and we'd see this often. Symptoms you are describing, and they'd run a course of time sometimes for several weeks, and just as strangely as they came on they resolved. However, go visit the gastroenterologist. They may very well want to do an EGD with biopsy to rule out Celiac as that is the only definitive way of determining. They may want to also order a gastric emptying test too, just to rule that out. In the meantime I'd avoid heavy food...if she does ok with the scrambled eggs keep that up, maybe even things like light yogurt...I have gastroparesis so when my flairs up, I use Glucerna shakes to get my nutritional needs. Monitor her blood sugars frequently and hopefully get that appointment with the gastro.

10

11

I’ll go along with the others and support that you visit a gastroenterologist. I suggest that you do not switch her to a gluten-free diet before going to the gastro because in order to get the best chance of being diagnosed with a gluten intolerance or celiac’s, the DOC needs to see her body responding to gluten.

12

Yes! I forgot about that! Don't eliminate gluten until after she sees the doctor!

13

Ok, thanks!! I forgot about the Glucerna or Boost shakes. I probably need to get some of those. Going to stick with avoiding heavy food too, until we get this figured out. I hope it could just be a virus, but it seems like something more and we just can't get a handle on it.

14

She uses MDI - she didn't like the pump. She's not on Symlin, but we have talked to the endo about it, mainly because she seems like she's always hungry -- until this happened. The regular doc gave her a phenergen prescription & it helps a little if she takes it at night, but it knocks her out. I don't know if she can handle taking that & going to school, because she has a lot of projects due know that the year is almost over & she has to stay up! Have you tried anything over-the-counter that helps?

15

Zofran is a MUCH better drug for nausea and does not have the sedative effects.

It's prescription but VERY good.

16

Stomach and gastrointestinal virus can wreck havoc. Having worked in Gastroenterology I've seen patients with symptoms up to about 6 months, and then they just resolve. But definately have her evaluated especially with the diabetes. If she does have gastroparesis or even celiac the sooner its discovered the sooner she will get to feeling better.

17

I don't know why my other post didn't load....
There seem to be numerous things it could be and the best bet is to see the doctor. But her symptoms seem a lot like what I went through before needing to have my gallbladder removed. If you're going to be keeping a food diary anyhow, consider trying to also keep track of the amount of fat in the foods your daughter is eating. The symptoms of gallstones can get worse on a high-fat diet and better on low-fat. (So mac & cheese could easily cause problems.) And once the gallbladder is inflamed it affects appetite for a few days. Having that extra bit of information might help the doctor narrow things down.
PS - Doctors often won't think of gallstones in younger people. But it's more common with T1 from what I've read. I had my surgery in my early 20s, so it does happen.

18

You can make Sam healthy low carb protein shakes using http://www.swansonvitamins.com/swanson-ultra-grass-fed-certified-rbgh-free-vanilla-whey-protein-powder-420-grams-14-8-oz-pwdr (comes in chocolate & vanilla).

Boost, Ensure & Glucerna are junk. They contain including fructose, soy oil, canola oil, corn syrup & maltodextrin. Nothing healthy in these.

Glucerna:
Water, Corn Maltodextrin, Sodium & Calcium Caseinates, Sucromalt, Glycerine, Soy Protein Isolate, Cocoa Powder (Processed with Alkali), Fructose, High Oleic Safflower Oil. Less than 2% of the Following: Canola Oil, Soy Oil, Plant Sterol Esters, Calcium Phosphate, Magnesium Chloride, Sodium Citrate, Soy Lecithin, Magnesium Phosphate, Natural & Artificial Flavors, Potassium Citrate, Choline Chloride, Potassium Chloride, Ascorbic Acid, Carrageenan, Potassium Phosphate, Acesulfame Potassium, Ferrous Sulfate, Sucralose, dl-Alpha-Tocopheryl Acetate, Zinc Sulfate, Niacinamide, Calcium Pantothenate, Chromium Picolinate, Manganese Sulfate, Cupric Sulfate, Vitamin A Palmitate, Pyridoxine Hydrochloride, Thiamine Chloride Hydrochloride, Riboflavin, Folic Acid, Biotin, Sodium Molybdate, Potassium Iodide, Sodium Selenate, Phylloquinone, Cyanocobalamin, and Vitamin D3.

Boost:

Water, Corn Syrup Solids, Sugar, Milk Protein Concentrate, Vegetable Oil (Canola, High Oleic Sunflower, Corn Oils), Calcium Caseinate, Sodium Caseinate And Less Than 0.5%: Potassium Citrate, Artificial Flavor, Magnesium Chloride, Magnesium Phosphate, Salt, Ascorbic Acid, Sodium Ascorbate, Beta-Carotene, Biotin, Niacinamide, Calcium Pantothenate, Vitamin B12, Vitamin B6 Hydrochloride, Thiamin Hydrochloride, Riboflavin, Folic Acid, Potassium Iodide, Calcium Phosphate, Soy Lecithin, Choline Chloride, Vitamin E Acetate, Vitamin A Palmitate, Vitamin D3, Vitamin K1, Carrageenan, Potassium Chloride, Zinc Sulfate, Manganese Sulfate, Cupric Sulfate, Chromic Chloride, Sodium Molybdate, Sodium Selenite, Ferrous Sulfate

Boost Glucose Control:

Water, Milk Protein Concentrate, Tapioca Dextrin, Vegetable Oil (Canola, High Oleic Sunflower, Corn Oils), Fructose, Cocoa Processed With Alkali, Calcium Caseinate, Sodium Caseinate, And Less Than 1.0%: Inulin, L-Arginine, Partially Hydrolyzed Guar Gum, Potassium Citrate, Citric Acid, Calcium Phosphate, Sodium Citrate, Salt, Microcrystalline Cellulose, Sodium Ascorbate, Soy Lecithin, Magnesium Phosphate, Vitamin E Acetate, Choline Chloride, Artificial Flavor, Beta-Carotene, Maltodextrin, Sucralose, Ascorbic Acid, Ferric Pyrophosphate, Zinc Sulfate, Biotin, Vitamin B12, Niacinamide, Carrageenan, Calcium Pantothenate, Manganese Sulfate, Cupric Sulfate, Vitamin B6 Hydrochloride, Thiamine Hydrochloride, Riboflavin, Vitamin A Palmitate, Folic Acid, Chromium Chloride, Vitamin D3, Potassium Iodide, Vitamin K1, Sodium Molybdate, Sodium Selenite.

19

Thank you!! Will ask about this.

20

Good idea, too, thanks. I've had my gallbladder removed & so have my mom & sisters, so it could be that too.