Posted on May 10, 2017 in Blog |
Brittany, a 21-year-old attending college, arrived at the doctor’s office complaining of bloating, gas, and diarrhea.
Brittany had been diagnosed with Celiac disease three years earlier in her home state of Colorado Springs, CO and successfully adhered to a gluten-free diet since then.
She also stated she had started to lose more hair than ever before, increased fatigue, and a low-grade, unexplainable fever.
The gastroenterologist ordered a colonoscopy and suggested she try a dairy free diet. He also drew blood to check her thyroid. The tests came back all within normal limits. No need to return, he stated.
“But what about my hair falling out? The diarrhea? My fatigue?” Brittany queried.
“We don’t know,” he replied. “Keep your diet gluten-free and dairy-free and you should see some gradual improvement.”
“And the fever?” she asked.
“You probably just had a virus. Make sure you get plenty of rest so your body can fight it off.”
Brittany left, frustrated once again.
Brittany’s symptoms had not restricted her lifestyle to the degree that things were impossible, but they were a major inconvenience. She didn’t go shopping with her mom because she couldn’t stand the thought of standing in lines and walking for hours. She chose her outings carefully based on their proximity to a bathroom in case diarrhea hit.
Otherwise, she was a reasonably healthy 21-year-old college girl.
After two hours in Dr. Mozayeni’s office, Brittany had a reasonable explanation for every symptom she was experiencing. Blood work results later proved his theory correct.
Bartonella is a chronic infection.
Chronic infection can cause chronic inflammation.
Inflammation worsens the function of the weakest part of a person’s body. For Brittany, it was her gut. The chronic inflammation in her gut made her susceptible to allergic reactions. When you introduce grains and dairy products to an inflamed area, you are more likely to produce an allergic or aggravated response. By omitting those allergens, the response will disappear, but it still doesn’t address the cause of the inflammation. Eventually, the bacteria will find another place to attack. In Brittany’s case, it was her thyroid and metabolism.
She started to lose her hair. But because she already had thick hair, her symptom was dismissed as insignificant.
“Everybody loses about 1000 hairs each day. You’re just becoming more aware of it lately.” Even though the thyroid test results were within normal range, the physician didn’t acknowledge this symptom was a significant change in Brittany’s body and should be addressed as such. And it didn’t fit in her category (or his specialty) of the Chief Complaint of diarrhea.
Brittany became lethargic, often worsening when she returned home to Colorado Springs on break. But because she was a college age student, the physician assumed she was not taking as good care of herself as she needed to. And, if he could resolve the Chief Complaint of diarrhea, she would probably develop more energy as a result as well.
Chronic inflammation can make it hard to tolerate high altitudes because the body does not receive as much oxygen as it does at lower altitudes. Less oxygen means less circulation; which means more inflammation. That is why Brittany became more tired when she went home. Her diarrhea increased when she was home. Her gut was more irritated and more likely to respond to any aggravating factor.
While removing the possible irritants from her diet was helpful, it still did not address the underlying cause of Brittany’s symptoms.
The gastroenterologist felt he had resolved the issue by having her omit gluten and dairy from her diet. Her Chief Complaint has been resolved for most the most part (but not entirely). But the gastroenterologist never looked a layer deeper to find the cause of the inflammation.
Because the other symptoms of low-grade fever, hair loss, and fatigue didn’t fit into the same category of his specialty, diarrhea, they didn’t fit into the algorithm and thus were discarded as insignificant, irrelevant, or at best, “does not compute.”