I've had various problems with my digestive tract for as long as I can remember. I was always the kid with the "sensitive stomach," or "nervous tummy." I can remember getting up and eating breakfast, and then feeling like I was going to have diarrhea (or, worse, having it), and having a lot of gas, before going to school. The family doctor prescribed Lomotil for me on several occasions; years later, I learned that Elvis had taken a lot of Lomotil, but instead of making me feel better about it, that made me feel worse: great, I'm taking opiates like celebrity drug addicts (I learned years later that I'd misunderstood what I'd heard, and that Lomotil isn't an opiate, it's that one of the main ingredients is an opiate receptor agonist). By that time I was in my teens, and I decided not to ever take it again, I'd just deal with my "tummy troubles" as best I could without drugs.
At some point -- I think I was in junior high school -- the doctor thought maybe I was allergic to milk; this was before "lactose intolerance" was a household phrase. He told my mom to switch me to low-fat, then non-fat milk. Now, at this point, that seems like a silly response: the fat content wouldn't have anything to do with the amount of milk protein present (which I could be allergic to), or with the amount of milk sugar present (which I could be intolerant of). But I'm old enough that this was in the dark ages of gastrointestinal medical knowledge, so we tried it. Non-fat milk seemed to help a little -- or was it just the placebo effect? Who knows. In any case, I went along as before, having occasional problems, but, generally speaking, nothing so chronic as to cause me to have to miss school or work on a regular basis (I don't actually remember ever missing school or work because of my occasional symptoms, but I may have forgotten an incident or two). What I did realize later was that all of this was having an impact on me, even if I didn't realize it: I would always take bathroom locations into account when I was traveling for more than an hour or two, and I'd be more cautious about what I was eating when I wasn't at home. I probably know the locations of all of the bathrooms at Disneyland better than any other non-Disney employee.
The first time I remember getting food poisoning -- or what I believed to be food poisoning -- I was in my 20s. I started to feel sick about 36 hours after I ate what I thought had caused the problem, had diarrhea, threw up, felt better, felt worse, threw up some more, and about 24 hours later felt dehydrated but basically back to normal. Over the next 20 years this happened to me many times, probably a dozen or more.
When I was in my late 20s, I decided to become a vegetarian. I'll go into that in another post, but suffice it to say I didn't do it for health reasons, although I did think that maybe it would help my wonky gut. It didn't seem to really make any difference, at least at first. But over the next decade or two, I did seem to have more serious problems with my gut (e.g., actual diarrhea instead of just feeling like I might get it) less and less often. Maybe my body was just trying to give me a break, since I seemed to get food poisoning so much more often than anyone I knew.
Over the years, there were a few times when I got what I assumed was some sort of intestinal bug: no serious pain to speak of, but just about anything I ate would cause diarrhea for a week or so. During those times I'd just eat as little as possible, and within a week I was feeling fine. This type of thing only seemed to happen every couple of years.
One of those episodes started in early December of 2010, just as my wife, Jenny, and I were heading to New Orleans before going to southern Mississippi to visit Jenny's mom. I didn't eat much in New Orleans, but by the second day in Mississippi I was pretty much back to normal. On the last night of our trip, however, we went out for dinner, and within six hours I'd developed major stomach cramps and I knew I was in for it. In the morning the sluice gates opened at both ends; it really seemed like it wasn't just me this time, because Jenny's brother was apparently up in the middle of the night throwing up. I felt better by noon, so we made the trip to the airport, but that was a big mistake: I was just in the middle of the "feeling better" phase, and by the time we were sitting on the tarmac in Houston in our connecting flight, with precious little air coming out the vents, I was feeling much worse. I ended up passing out in the bathroom and getting escorted off the plane by paramedics. Since the only flight back to the Bay Area the next day was full, we ended up spending two nights at the Airport Hilton or Marriott or Something without our luggage. Probably the worst travel nightmare of my life, courtesy of my wonky gut.
Then, three months later, it happened again: I couldn't really eat anything without it causing diarrhea. On top of that, I was nauseous, and I had some lower abdominal pain, which was unusual. After a couple of days the pain had decreased enough that I wasn't worried, but the episode concerned me a little.
And then, after another three months, it hit again, and the pain was worse. I decided I was concerned enough to see a doctor, and I was fortunate enough that the gastroenterologist I'd seen several years earlier about reflux had had a cancellation, so I was able to get in to see him in two days instead of six weeks. By then the pain had decreased, but it was still there, and when he pressed in at McBurney's Point it made itself quite obvious. So he sent me to the emergency room across the street, and late that night I gave birth to an unhealthy appendix. Not ready to burst, but definitely inflamed.
Before the operation I was a bit nervous, but I was pretty excited, too: could it be that my appendix had been the cause of my problems all along? Could it be that my tummy troubles were over for good?
Alas, no, it could not. In fact, they got a whole lot worse. A week after the operation I was back to bland but normal food, and I was having serious diarrhea, along with a fever. I went to an emergency clinic, but they checked everything and said that it all seemed in order. The fever eventually came down, but the diarrhea didn't stop, so I saw the surgeon for a follow-up appointment and he was concerned about the possibility of c. diff., so he consulted with my gastroenterologist and put me on the standard drug for that nasty pathogen, metronidazole; there was a slight improvement, but very slight, and when the course was over the slight improvement vanished. That wasn't surprising, since the symptoms didn't really rise to what you'd expect to see from a c. diff. infection. I started working with my gastroenterologist, who put me on probiotics, and a short course of Rifaximin, neither of which did more than a tiny amount of good. He ran every test available for parasites and bugs and what not, all of which came back negative. In the end, I was left with a diagnosis of Irritable Bowel Syndrome. That made me very unhappy, since it was clear that although I'd had problems in the past, the current level of symptoms were somehow caused by the appendectomy.
So I started reading. Well, I'd actually started reading whatever I could find on gut problems right after the operation, when I was still excited about the possibility of having eliminated mine. But now that it was clear that just the opposite had happened, I was reading for a whole different reason: I figured I was my only hope.
In the end, the point that I got to was 1mg of loperamide (Immodium) twice a day. That seems to keep the symptoms at bay 80% or so, and it's a very low dose: many people with Crohn's Disease or Inflammatory Bowel Disease take many times that amount every day. But I wasn't happy about having to take a drug every day for the rest of my life for something that nobody can even explain. So, based on that unhappiness and a test result that I'll go into later, I'm trying a different approach.
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