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Old 06-08-2008, 02:43 PM   #1
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No appetite, weight loss and abdominal pain

I started losing my urge to eat and really have to make myself eat a decent meal - although it's probably more in line, per portion size, that we should eat. I drink coffee and diet coke, sometimes decaff...mood is level (I'm mild bipolar II). Great news is that since Sept 2007 (shortly after starting these two meds - BTW, Vyvanse 70mg and Lamictal 300mg daily for bipolar) I've lost 55 lbs....that is wonderful (I was 220lbs and am only 5' 5"). My pdoc told me that a side affect of these two meds was weightloss...great news for me as I was very overweight when I started them late last summerI
One of the top side-effects of Vyvanse (and lamicatal) is abdominal pain...I've tried the BP board, but got no response as to how painful the abdominal pain might be in those that take it.

So, in January, I started having very painful abdominal pains that would last a day or so and then go away; only to come back in a week or so. No change in bowel movements, except somewhat less as I'm eating less. I initially thought the pain was due to the NSAID the orthopedist had me taking due to a neck injury in Sept. I stopped taking those right away.

Actually wound up in the ER last week as the pain fit gallstones - which is sometimes a downside to weightloss. Ultrasound of gallbladder was fine, CT of abdomen showed 2cc cyst on right ovary. GYN didn't see any need to remove it after a transvaginal ultrasound - said it couldn't be causing the pain. I also had an endoscopy in January which was fine - minor gastric polip that was benign and I take Aciphex for acid/heartburn...occasionally get a breakthrough and need Tums - but rarely.

Pain has been mainly on my right side up under the right rib cage is and sometimes radiates around to my back. Now, after a painful vaginal/rectal digital exam (where I was torn -blood in both areas when I cleaned up) - of course there was blood in the test...so my GYN wants me to have a colonoscopy. I'm 41 and haven't had one before - supposed to start at 50. No change in bowel habits - always been one of those who will have a bm at least 1 time daily and very rarely get constipated. I did a home fecal blood test this weekend - all negative results.

Has anyone had this and where is the pain and how often? I would like to start with a less invasive procedure than to colonoscopy because it seems so invasive when it feels like we are just chasing after a wild goose. My CBC was fine at the ER...liver functions good...seemed very good and the DR doctor really thought it was the ovarian cyst that the abdominal CT found.

Personally, I'd just as soon them remove my ovary (at 41, my family is complete) and even the gallbladder.

Anyone have any ideas? Sorry for the long post!
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Old 06-08-2008, 06:16 PM   #2
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estria HB Userestria HB Userestria HB Userestria HB User
Re: No appetite, weight loss and abdominal pain

Hello,

A 2 cm simple ovarian cyst will go away on its own and does not need surgery. Women grow cysts on their ovaries every month which release eggs into the fallopian tubes during ovulation. Then the cysts are reabsorbed into the ovaries until after your period when they begin to grow again. 2 cm is well within the norm for an ovarian cyst (mine, for example is 8 cm and I am keeping an eye on this with ultrasounds in case it grows any bigger .. fortunately it is a simple cyst, meaning filled only with fluid). Why did your doctor say that the medication you are taking causes weight loss ? Does it perhaps cause loss of appetite ? This may be the reason for your lack of appetite. Why does your doctor recommend a colonoscopy if your bowel movements are normal ? Do you perhaps have colon cancer in your family ?.. if so, colonoscopies should start at the age of 40 or at the age your relative was diagnosed. This is because colon cancer is a very treatable disease if caught early.

I would begin by questioning the side effects of your meds first and if this is not the cause, then go for another ultrasound to ensure that the ovarian cysts have been reabsorbed (going while you are on your period will reduce the chances of finding ovarian cysts on your ovaries during the ultrasound). GI issues would be the natural next step so a colonoscopy may be in order (or at least a sigmoidoscopy + occult blood test (guaiac .. sorry about the spelling)).

Take care and I hope you find some answers ...

 
Old 06-08-2008, 06:48 PM   #3
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Re: No appetite, weight loss and abdominal pain

Estria, thanks for the reply.

The meds are noted for decrease in appetite; so, to me that was explainable. And, the weight loss started within a few weeks of taking it. 55lbs over 10 months doesn't seem bad - but, it seems to be the recurring stomach pains that stay for about 2 days around once a week or so. The pains make me want to press on my stomach, so there is no tenderness anywhere...???

No family history of colon cancer except my maternal grandfather had it; but no chemo, etc.

The only different thing about the ovarian cyst; is that I did have a uterine ablation 2 years ago; so rarely even have symptoms of PMS or when I should have a period. Not sure if this is even relevent; but my GYN was the one who did it - and I've also read - like you said that 2cm cysts are pretty common and don't need removal. Mine is a dermoid cyst. The only reason my GYN dr said the next step was a colonoscopy was because she said the fecal occult test she did right then was positive...well, it should have been the way she did it. I've had her do one other at my yearly GYN visit (in Jan of this year - literally a few days after my stomach pains started) and it was negative.

I've calmed down and think that you are right - I'm going to contact my pdoc tomorrow about the Vyvanse and Lamictal abdominal pain side affects that she might have seen or read about in journals. She knows of the weight loss as I saw her about 6 weeks ago and said as long as I wasn't NOT eating; not to worry at this point...that I'm still not underweight, in fact still about 20lbs overweight for my height.

After I've talked to her, I'm going to schedule a visit with my Gastro dr and talk rather than act impulsively. In defense of my GYN, I think she saw my fear when she told me it couldn't be the cyst causing the pain and suggested the colonoscopy as I had been hurting enough to go to the ER earlier in the week. I was so convinced it was the ovarian cyst, that I was just ready to have it out and be done with all of this. BTW, I've only been to the ER 3 times (this was the 3rd) in my life...1st I had viral meningitis, 2nd chest pains due to too quick of withdrawel from a prescribed med and this time. To me, you have to be bleeding to go to the ER, and it was like this past day of abdominal pain was the straw that broke the camel's back.

Anyway - thank you again. I'll reply once I hear something this week.
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Old 06-09-2008, 07:06 AM   #4
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estria HB Userestria HB Userestria HB Userestria HB User
Re: No appetite, weight loss and abdominal pain

Hello again,

Perhaps the colonoscopy might not be a bad idea so that you can rule out anything in the colon once and for all. Althought the prep is not very pleasant, the actual procedure is quick and painless since a sedative is administered. People describe the experience as waking up from a very restful sleep (my mother has had it done and said the same thing). The other explanation might be your stomach. You mentioned having a polyp before so it may have something to do with either the polyp or an ulcer or something of the like. An endoscopy would confirm or negate this as well.

You may also want to try ingesting more fibre and a daily probiotic supplement. Both fibre and probiotics come in capsule form so you would not have to increase your food intake.

Good luck with your search for answers and all the best.

 
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