There are literally hundreds of conditions or causes to recurrent abdominal pain and nausea associated with eating, both physiological and psychological in nature. Considering the stomach is the primary organ of the digestive process and has connections to almost every area of the body, it’s not surprising that abdominal dysfunction is a common complaint by many of us that suffer with chronic illness. Reaching a diagnosis for problems associated with the digestive system are tricky, as it is a common complaint of both healthy and chronic patient’s alike. Unfortunately, if your pain or nausea is caused by something other than the usual suspects, especially in conjunction with other non-specific or symptoms, doctor’s can easily write it off as being “in your head”.
When initial diagnostic tests come back normal and it’s not easily explained by one of the many favorable conditions, then one of two things will happen. Either 1) the doctor will diagnose you with Irritable Bowel Syndrome (IBS) or 2) Determine it’s related to stress or a psychological disorder. No further testing required. In my opinion, using both IBS and stress as a diagnosis is a cop-out and the doctor is being lazy. While I am not saying that IBS does not exist, I feel doctors use it too often without further investigating a differential diagnosis. For both IBS and stress alike, all kinds of pills and pharmaceutical interventions will be thrown at you, without evidence that you even have any of these conditions. So when the medicine does not work, or has minimal effect, then “you’re just crazy”.
I can’t tell you how many doctor’s, both in general practice, as well as specialty, that have told me to seek psychological intervention. They ran minimal tests, tried every medication on the market to “treat my symptoms”, so then obviously… it must be for attention then. What’s worse is I started to believe them. Between these doctor’s not believing me, friends and family not understanding (who even to this day can ask me if it’s not all “stress related”), and no reasonable explanation for all the pain I felt every single time I would eat, how could I not think I was crazy? I went to therapy and counseling multiple times. And even when I was deemed “cured” from all the anxiety related diagnoses, the pain only got worse. In fact, after being “panic attack free” for so long, my abdominal symptoms are the worst they have ever been.
As I mentioned in a previous post, I initially “treated” the pain I would get after eating by simply putting the associated food on my avoid list. But after years of food making me sick, the list of trigger foods became so large, it was easier to have a list of the minimal number of food on a “safe list”. This behavior also brought on associations between foods, as one time I got sick when I had this and then had that within a few hours, so they “mixed bad”. My friend Stacie would always point out that she had never met anyone who had to think so decisively about they had consumed in a day to determine how it would all come together. Just recently, actually, in a letter she kindly wrote for me on my condition, she stated, ” I have known Nikki for over 4 years, so have gotten to see how her health issues started, and have progressed. When we first met, Nikki had issues with certain foods and certain drinks and how they would “mix”. ” It’s almost a joke among my close friends because they know there is so much thought that goes into the timing and choice of foods. It’s unfortunately, my coping mechanism, and the only true control I have over my undiagnosed pain.
So let's put this diagnostic scenario together:
- She’s a young female at onset of symptoms.
- She HATES food. In fact, she says it makes her “sick”.
- All initial diagnostic test are normal.
- She has anxiety and IBS. She’s reported psychology treatment.
- She organizes her food choices into very specific categories.
- She “restricts” food to have “control” and refuses to eat many times.
- She has, at many times in her life, been extremely underweight.
And if you haven’t put the pieces together yet,
I was sent to therapy for diagnosis and treatment for anorexia.
In a way, depending on how you look at it, I DO have an eating disorder. And it is definitely being managed inappropriately and I may have some irrational thoughts as far as the extent of my “trigger list” of things I can’t eat, which I rationalize to myself is to not have associated discomfort and symptoms. Also, it is greatly impacting and disrupting my life. However, in determining if this is abnormal or not, essentially it can be weighed to both sides. If doctor’s could offer answers and a diagnosis, then I’d be able to manage and treat my symptoms properly.
Luckily, or maybe not so luckily at this point, all systems of my body are now being effected by my illness and symptoms have finally become visual and undeniable. It’s easy to write-off subjective symptoms as being overly dramatic or attention-seeking. Hell, I’ve been accused and treated like I was drug seeking, when I have an extremely low tolerance to pain medications. I mean, let’s be real here. I CANNOT EAT FOOD WITHOUT BEING SICK, I obviously do not want to take any harsh drugs that will only make the nausea and stomach pain worse. I want to feel better!!!!! But now that they can’t deny that something is wrong, I am finally getting the testing I need to figure it out, beyond the initial scope that my earlier doctors refused to consider. It’s been a long fight to get here, more than it should have been, but at least I am on my way in finding a TRUE diagnosis.
Next tests up: