[49F] With chronic abdominal cramping and watery diarrhea

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations for your condition:

Chronic Diarrhea and Abdominal Cramping

1. Irritable Bowel Syndrome (IBS): Given your family history of IBS and the chronic nature of your symptoms, IBS is a strong possibility. IBS often presents with abdominal cramping, diarrhea, and alternating bowel habits. Stress and certain foods can exacerbate symptoms.
2. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis could also explain your symptoms, especially given your family history. These conditions can cause chronic diarrhea, abdominal pain, and weight loss. However, a negative colonoscopy makes this less likely but not impossible.
3. Microscopic Colitis: This condition can cause chronic watery diarrhea and is often missed on standard colonoscopy unless biopsies are taken.
4. Bile Acid Malabsorption: This can cause chronic diarrhea and is often underdiagnosed. It can be confirmed with specific tests and treated with bile acid binders.

Profuse Sweating During Bowel Movements

1. Autonomic Dysregulation: Conditions like IBS can sometimes affect the autonomic nervous system, leading to symptoms like sweating during bowel movements.
2. Anxiety or Stress: These can exacerbate gastrointestinal symptoms and cause sweating.

Severe Heartburn

1. Gastroesophageal Reflux Disease (GERD): Your severe heartburn and acid reflux symptoms are consistent with GERD, which can be managed with medications like pantoprazole.

What you can do

For Chronic Diarrhea and Abdominal Cramping

• Consult a Gastroenterologist: Given the chronic nature and severity of your symptoms, a specialist can help with further diagnostic tests and tailored treatments.
• Dietary Changes: Consider a low FODMAP diet, which has been shown to help with IBS symptoms. Keeping a food diary can help identify any potential triggers.
• Medications: Continue taking hyosciamine as needed for cramping. Discuss with your doctor the possibility of trying other medications like bile acid binders or antidiarrheal agents.
• Hydration: Ensure you stay well-hydrated, especially with frequent diarrhea.

For Profuse Sweating During Bowel Movements

• Stress Management: Techniques like mindfulness, meditation, or yoga can help manage stress and potentially reduce sweating.
• Medical Consultation: Discuss this symptom with your doctor to rule out any underlying autonomic issues.

For Severe Heartburn

• Continue Pantoprazole: Ensure you take it as prescribed. If symptoms persist, your doctor may need to adjust the dose or try a different medication.
• Lifestyle Changes: Avoid foods and drinks that trigger reflux, eat smaller meals, and avoid lying down immediately after eating.

General Tips

• Symptom Journal: Use MDandMe to journal your symptoms, track progress, and get insights. This can be very helpful for your healthcare provider to understand your condition better.
• Regular Follow-ups: Keep regular appointments with your healthcare provider to monitor your condition and adjust treatments as necessary.

What you should look out for

Given the chronic nature of your symptoms, it's important to seek medical care if you experience any of the following:

• Severe abdominal pain that doesn't go away
• Blood in your stool
• Unexplained weight loss
• Persistent vomiting
• Signs of dehydration such as dizziness, dry mouth, or reduced urine output

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan.